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The newsweekly for pharmacy 

January 28, 1995 

Zl Contains diphenhydramine 



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PSNC claims 
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Tagamet mailing 
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Time up for 
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Glaxo in £8.9bn 
Wellcome bid 
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Distributed by: Whitehall Laboratories Ltd., Huntercombe Lane South, Taplow, Berks , SL6 0PH 



I l»l I OKI \l 

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A United Newspapers publication 


VOLUME 243 NO 5968 


ISSN 0009-3033 

PSNC goes for 4.5 per cent 1994-95 global sum rise for contractors 1 1 2 

DoH says English and Welsh pay deal unlikely by April; SPGC looks lor offer soon 

Tagamet consumer 'indigestion mailing' to be looked at by Society 1 13 

'Leaflet is very good ... but is patient-specific OTC promotion desirable ...?' 

National milk token scheme has been put back to 1996 1 14 

Interim local schemes could be put back as well, says PSNC's Godfrey Horridge 

C&D looks at the debate over the faxing of scripts by non-contract pharmacies 130 

News review: will the DoH outlaw the practice? 

How to maximise sales with minimal cash outlay 134 

Shopfitting: special feature 

American-style managed care 138 

John Donohue gives his views on the US experience 

Is it time for a natural medicines licensing re-think? 144 

Larkhall logs a century as Robert Woodward speaks out 

Glaxo bids £8.9 billion for Wellcome in putsch 146 

World number one spot dependent on Trust decision 

Gatenby notes pharmacy prescribing influence ... 147 

... while Zyma win CcGDsponsored Craft Award from PMS 


Topical reflections 


Medical matters 


Script specialities 


Questions & answers 


News extra 




Business news 


Coming events 


Classified advertisements 


Business link 





It's the time of year when PSNC and the Department of 
Health square up for their annual tussle over pharmacists' 
pay for the coming year. PSNC has opened the campaign 
this week, making effective use of the pharmaceutical 
press to lambast the Department for failing to respond to 
its claim, lodged at the beginning of December. There is 
little original in what PSNC is asking for. The Department 
might dispute its bid for a 4.5 per cent increase in the 
global sum and new money for new roles, but there are 
some facts with which it cannot argue. The first is that 
community pharmacists' gross profit is in rapid decline. 
The second is that, once more, there will be no pay 
settlement in place by April 1. At least the Department has 
come clean early on this score, blaming its own internal 
upheavals for the delay, although this is scant consolation 
to pharmacists who have businesses to run. The third is 
that in spite of repeated inquiries from PSNC the 
Department has refused to say what will happen about the 
interim professional allowance for pharmacies dispensing 
between 1,000-1,500 items a month. PSNC has 
campaigned hard to make the allowance (which is due to 
finish at the end of March and could cut some small 
contractors' income by 20 per cent) a permanent feature. 
Chemist & Druggist 28 JANUARY 1 995 

The Committee probably remembers all too clearly the 
accusations of two years ago that it was selling small 
contractors down the river, and the publicity whipped up 
by the Pharmacy Support Group. 

So far PSNC is ahead on points. It should get an offer in 
time to allow it to reach a concensus in time for the LPC 
conference in early March, allowing contractors to be fully 
briefed on the likely level of settlement. One benefit (if 
that is the right word) of a late offer from the Department 
is that the Doctors and Dentists Review Body should have 
made its recommendations by the end of February. This 
could give PSNC more ammunition if yet again the 
Department offers less to pharmacists than to the other 
health professions. But as always, in the end. the 
Department has the power of imposition. PSNC's 
parliamentary lobby appears to be growing, however, and, 
with a Government which has a steadily slimming 
majority, should become increasingly effective. The 
Department says the pharmacy pay package is still in a 
transitional phase, moving towards a single-tier fee and 
more devolved payments via local authorities in 1996. 
With this in mind, its offer to PSNC might be more 
evolutionary than the Committee perhaps anticipates. 


PSNC seeks 4.5pc rise 
in 1995-96 global sum 

Pay deal 
unlikely by 
April, says 

The Department of Health is 
unlikely to make a formal pay 
offer to contractors in England 
and Wales before the next 
meeting of the PSNC on February 
14. In consequence, "it is 
reasonable to assume that a 
settlement will not be in place by 
April 1", says DoH undersecretary 
Melvyn Jeremiah. 

He blames the delay on the 
internal reorganisation at the 
Department. "The intention has 
been to bring into effect the 
reorganisation of my branch 
before engaging with the PSNC 
on pay," he says. 

The Department is still 
considering what shape the 
1995-96 package ought to be, 
bearing in mind the move to a 
single-tier dispensing fee and the 
wish to move rapidly towards 
devolution to local budgeting in 
March, 1996. 

"These requirements are mak- 
ing us think very hard about the 
shape of this year's package," says 
Mr Jeremiah. 

He says the Department is still 
undecided on the fate of the 
interim professional allowance, 
which is due to be wound up at 
the end of this financial year. 

The PSNC is up in arms over 
the delay. Community phar- 
macists in England and Wales 
have no idea what their NHS 
income will be in the coming 
financial year, making any 
business planning difficult. 

"Year by year the offer is being 
made later and later," says PSNC 
chairman David Sharpe. "In the 
past we might have expected to 
see an offer by December." 

Department officials have been 
told that the Committee is 
"particularly concerned at the 
cavalier treatment being meted 
out to chemist contractors", he 

The Committee has still had no 
answer to its representations on 
the interim professional allow- 
ance. "Contractors in this band 
could face a cut of 20 per cent in 
their income if it is scrap- 
ped, "says Mr Sharpe. 
• The PSNC's lobbying of some 
90 MPs last year to persuade them 
of the need to maintain the 
professional allowance for small 
pharmacies is bearing fruit. 

Dafydd Wigley (Plaid Cymru) is 
the latest MP to raise the matter. 
In reply to a question in the 
House of Commons last week, the 
health minister, Gerald Malone, 
said there have been a further 
seven representations about the 
graduated transitional payment. 
"This is a matter which we expect 
to discuss with pharmacists' 
representatives in the forth- 
coming pay round," he said. 


Pharmacy negotiators for England 
and Wales have put in a claim for 
a 4.5 per cent increase in the 
global sum for 1995-96 to the 
Department of Health. This 
would boost the global sum from 
its 1994-95 level of £655.3 million 
to £684.8m. 

Pharmacy contractors face a 
forecast increase in costs in the 
coming year of between 3-4 per 
cent, says the Pharmaceutical 
Services Negotiating Committee, 
in addition to an expected 
increase in prescription volume 

The Scottish Pharmaceutical 
General Council is optimistic 
that the overdue pay deal for 
1994-95 will be revealed "very, 
very soon". 

According to SPGC chairman 
Andrew Taylor, discussions with 
the Scottish Office of the Home 
and Health Department should 
result in an announcement 

Sharpe writes 

David Sharpe, chairman of the 
Pharmaceutical Services Neg- 
otiating Committee, has written 
to health secretary Virginia 
Bottomley expressing his con- 
cern over dispensing doctor 
activity in Hertfordshire. 

Hertfordshire-based pharma- 
cist Ralph Lightstone, already on 
the family health services 
authority's pharmaceutical list, 
applied to open a second 
pharmacy in the village of 
Watton-at-Stone last October. 
Despite opposition from local 
dispensing doctors, the FHSA 
granted preliminary consent (see 
C&D December 24/31, p988). 
However, Mr Lightstone with- 
drew his application this week, in 
the face of threats made against 
him and the pharmacy, if and 
when it opened. 

Mr Sharpe has now brought 
the matter to the attention of Mrs 
Bottomley in a letter which 
complains of the doctors' cam- 
paign to incite local people into 
opposition against Mr Lightstone. 

He urges Mrs Bottomley to 
make it clear to the General 

Infacol recall 

Pharmax is recalling six batches 
of Infacol 50ml, following 
evidence of some microbial 
contamination. The following 
batches should be removed from 
sale: 41616, 41617, 41618, 41619, 
41719, and 41720. Tel: 01322 
550550 ext 325 for details. 

of 3.6 per cent. 

Contractors' productivity over 
the past few years has never been 
fully reflected in the global sum, 
says PSNC chairman David 
Sharpe in a claim sent to the DoH 
in December. 

Financial attrition in recent 
years has seen average core gross 
profit falling from 23.1 per cent in 
1987-88 to a forecast 16.5 per 
cent for 1994-95, and "this 
situation must be addressed", 
says Mr Sharpe. 

The PSNC is also seeking to 

before the end of February. 

Although the offer appears late, 
Mr Taylor notes that historically 
Scottish pay deals have been 
settled at this time. There has not 
been any real dispute with the 
Scottish Office, he says, ant- 
icipating an offer similar to the 
2.3 per cent increase in global 
sum seen in England and Wales. 

to Bottomley 

Medical Services Committee that 
she deplores such intimidating 
campaigns by GPs and asks her to 
ensure similar tactics are never 
again used by doctors elsewhere. 

"What has happened in this 
case is contrary to the best 
interests of patients and the 
NHS," he says. 

increase advance payments to 
contractors from 80 per cent to 
"at least 95 per cent" from April 
1, and insists that this extra 
money must not be deducted 
from the global sum. 

The Pharmacist Review Panel 
has supported PSNC's case. "In 
our view the DoH is not meeting 
the spirit of the Government's 
own guidelines on prompt 
payments," says Mr Sharpe. 

The PSNC insists that com- ; 
munity pharmacists are willing ' 
to play their part in the j 
development of primary care j 
services, but says it is totally i 
unreasonable to take money from 
existing dispensing fees to fundi 
new roles. 

"New roles should be funded 
with new money, and we expect ji 
that additional monies will be 
found to fund advice to nursing 
homes, which is included within 
the roles being discussed at local I 
level for 1995-96," says the 

Although detailed fee changes:; 
will be discussed once the global m 
sum has been finalised, PSNC is , 
seeking change in two areas: 

• the expensive prescription;! 
allowance of 1 per cent is totally u 
inadequate, says the Committee. 
A 2 per cent allowance "would I 
help alleviate the problem" 

• interim payments for contrac- L; 
tors dispensing between 1,000 1 
and 1,500 items a month should! 
become a permanent part of the 
professional allowance. 

Forty-plus pharmacies 
faxing scripts 

A survey of pharmacies in 
England and Wales has revealed 
the existence of at least 89 
non-contract pharmacies, of 
which 40 are reported to be 
transferring NHS scripts. 

Eighty-nine LPCs out of a 
possible 98 responded to a survey 
by the PSNC. Secretary Steve 
Axon points out that these are 
minimum figures since not all 
LPCs responded, and there may 
be non-contract outlets in some 

areas that the LPCs are not aware 

Health minister Gerald Malone 
wrote to the PSNC on January 9, 
saying he is aware that there is 
considerable strength of feeling 
in the profession about the 
handling of NHS prescriptions by 
non-contract pharmacies. 

He assures the Committee that 
its concerns will be borne in mind 
if changes are being made to the 
control of entry regulations. 

Distribution of non-contract pharmacies 

No of No of No of No of non-NHS pharmacies 

non-contract FHSAs non-NHS transferring NHS Rx 
pharmacies pharmacies None Transfer Don't know 







































Chemist & Druggist 28 JANUARY 1995 

SPGC hopeful of offer soon 

NHSE throws cold water on PBM move 

The NHS Executive is advising 
health authorities and CP 
fundholders not to sign deals 
which link prescribing to a 
specific company's products. 

The letter to NHS managers 
says that pharmaceutical com- 
panies have been offering disease 
management packages or similar 
deals for the preferential pur- 
chase of drugs. Much of the 

The Council of the Royal 
Pharmaceutical Society is to look 
at the promotion of product- and 
patient-specific pharmacy only 
medicines, following an outcry 
over a recent Tagamet mailing. 

The Smithkline Beecham 
mailing was specifically targeted 
at 250,000 indigestion sufferers, 
highlighting the brand and 
preparing sufferers for a phar- 
macist's questions. It is under- 
stood that this is the first time 
that such a specific promotion 
has been conducted. 

Pharmacists were told of the 
mailing via a simultaneous trade 
mailout. Although the leaflet 
promotes the pharmacist's ad- 
visory capacity and does not 
contain any information outside 
Tagamet's licensed indications 
ind uses, Manchester pharmacist 
Micola Gray questions where the 
inailout leaves the pharmacist. 

"1 believe it is setting a 
>recedent. Somebody is going to 
:ome in and wave this leaflet at 
Tie. Tagamet is a dangerous drug 
ind this leaflet undermines the 
'harmacist's ability to make a 
'rofessional judgment." says Ms 
pray. It may also encourage 
consumers to dodge a phar- 
nacist's questions, she says. 

Concerned over the ethics of 
uch an initiative, the RPSGB's 

thinking stems from phar- 
maceutical benefit management 
schemes in the US, in which a 
company offers support services 
and financial discounts in return 
for which it receives an exclusive 
supply agreement. 

The letter adds that, in 
principle, the Executive does not 
oppose collaboration between 
companies and the NHS, but 

law and ethics department is to 
examine patient- and product- 
specific promotions at its next 
Council meeting. 

Sue Sharpe, director of legal 
services at the Society, says: "The 
question is whether patient- 
specific promotion of an OTC 
product is something that the 
profession would regard as 

"The leaflet itself is very good; 
it reinforces the importance of 
talking to a pharmacist. But as a 
development, promotional mat- 
erial that is so patient- and 

If the yellow card reporting rate 
does not improve, then input 
from community pharmacists 
will be considered, the De- 
partment of Health has now 

A DoH spokesman for the 
Committee on the Safety of 
Medicines reveals that the 
current decline seen in yellow 
card adverse drug reactions 
reports was "substantial" and was 
causing it sufficient concern to 
consider other avenues. One of 
these would be community 

further discussions are needed 
before any agreements can he 

The agreements could infringe 
competition law, breach con- 
fidentiality and even undermine 
the Pharmaceutical Price Reg- 
ulation Scheme. Local deals 
could also distort discount 
clawback and reimbursement 

product-specific is something 
that the Society's law and ethics 
division will be looking at. 

"There is a "concern that 
de-POMed medicines which have 
been aggressively promoted may 
be leading to inappropriate 
self-medication. The more in- 
formation that goes direct to 
consumers, the more risks there 
are," she says. 

Smithkline Beecham says that 
it is "delighted that the Royal 
Pharmaceutical Society has ack- 
nowledged the appropriateness of 
the campaign". 

pharmacy, she says. 

A recent report from the 
Committee showed that yellow 
card reports had fallen 12 per 
cent between 1992-94 from 
20,161 to 17,698. It has also been 
stated that only 10 per cent of 
adverse reactions are reported. 

"At the moment the res- 
ponsibility rests with GPs. But if 
it [the decline] continues, and 
there is no evidence that the 
reporting rate is going up. then 
other avenues will have to be 
looked at," says a spokesman. 


fee for 

Pharmacists within the Greater 
Glasgow Health Board area could 
soon he seeing payment tor 
supervising the dispensing of 

The Board's chief admin- 
istrative pharmaceutical officer, 
I )r I loward McNulty, has revealed 
that funds for a supervision 
service fee are available and that 
discussions with the local 
Chemist Contractors Committee 
will hopefully result in a pay deal 
before the end of the financial 

Exact details on how much 
money and how many phar- 
macies will be involved are, as yet, 
unavailable. Some estimates 
place the number of potential 
participants in the scheme at over 

Compared with the rest of 
Scotland, Glasgow has been slow 
to set up methadone prescribing 
programmes, only coming on 
board in October, 1993. 

However, community phar- 
macy participation in methadone 
administration has been en- 
couraged since January, 1994 
and, due to the extent of the drug 
addiction problem in the area, 
pharmacists' role in meeting 
demand levels is increasingly 
being understood. 

"The doctors involved [re- 
cognise] that supervision of 
methadone administration is an 
integral part of the programme 
and that existing services are not 
able to cope with the problem 
levels that we have," says Dr 

New service 
standards for 


A schedule of service standards in 
hospital pharmacy care has been 
published by seven organisations 
representing hospital pharmacy 
and pharmacists. The seven-point 
schedule is intended to com- 
plement existing standards in 
hospital pharmacy services, 
including those incorporated in 
the code of ethics of the Royal 
Pharmaceutical Society. 

The standards for good 
pharmacy practice in hospital 
care cover: suitability, availability 
and quality of medicines: 
assessment of pharmaceutical 
care needs; dosage, delivery and 
duration: patient monitoring on 
an individual basis; staff training 
and practice research; provision 
of evaluated, independent drug 
information: and continuity of 
care across the primary/sec- 
ondary care interface. 

Tagamet mailing evokes 
action from Council 

DoH looks to pharmacy for 
yellow card input 

hemist & Druggist 28 JANUARY 1995 


Milk token scheme 
put back to 1996 

A national welfare milk scheme 
through pharmacies will not be 
in place this year, according to 
the Pharmaceutical Services 
Negotiating Committee. 

"We are now looking at a 
national scheme by April 1, 
1996/' says PSNC financial 
executive Godfrey Horridge. 
"This suggests interim local 
schemes might be back on the 

The Department of Health has 
been asked as a matter of urgency 
to increase funding for local 
schemes until a national one is 

established. Many local initiatives 
have run into trouble when 
funding through health auth- 
orities has dried up. 

This latest development comes 
after a meeting with the DoH was 
cancelled last week. An internal 
review of the scheme indicated it 
would not be in place by this 

Negotiations reached an im- 
passe before Christmas (C&D 
December 24/31, p987) over the 
fee deal which would have given 
pharmacists just 3()p over the 
cost price of the infant formula. 

During a recent visit to the North West region, health minister Gerald 
Malone visited the Cytotoxic Drug Reconstruction Unit at Christie 
Hospital, Manchester, where manager Andrew Goldney (left) showed him 
how drugs tailor-made to cancer patients' individual needs are 
manufactured from constituent parts. During the visit, iMr Malone 
unveiled a new £1 million primary care resource centre in Salford, one of 
three such centres in Greater Manchester. These have been funded by a 
£9. 4m regional grant 

PSNC to remain at 25-strong 

The Pharmaceutical Services 
Negotiating Committee has 
dropped a recommendation from 
its constitutional working party 
that its size be cut from 25 to 16 
members. The working party had 
proposed cutting down the 
number of NPA nominees from 
five to two, and the number of 
regional representatives from 15 
to nine. 

Nor has the PSNC adopted 
wording which would have seen it 
representing "the general body of 
pharmacy contractors in England 
and Wales" (C&D January 21, 
p81) rather than "the interests of 
all NHS pharmacy contractors". 

PSNC has decided, though, 
that all the committee members 
should have deputies. 

Other changes recommended 
by the working party were: 

• a new Section 3.9 to be added to 
the constitution to reflect the 
duty of PSNC to advise LPCs in 
local negotiations 

• terms of office to commence on 
April 1 in line with LPCs 

• PSNC represents contractors 
so it was not thought appropriate 
for there to be employee places 

• a proposal to establish a PSNC 
regional structure to support 
LPCs was abandoned since the 
benefits would not outweigh the 
annual estimated cost of 

• a proposed LPC model con- 
stitution was set out. Nine-person 
LPCs are encouraged to opt for a 
membership of 15 and should be 
required to hold an annual 

• proposals that PSNC should 
become a limited company (like 
the GMSC) were rejected 

• proposals that PSNC should 
publish full reports of its 
meetings were rejected 

• observers should be able to 
attend PSNC meetings. 

LPCs will be given a chance to 
debate the working party report 
at March's LPC conference at the 
Queen Elizabeth II Conference 
Centre in London. This is a two- 


day event starting on Sunday, 
March 4, and winding up with the 
PSNC dinner on Monday evening. 

Reports from the working 
parties looking at the con- 
stitution and compensation for 
small pharmacies facing closure 
will be debated on Sunday 
afternoon, even though LPCs 

have no power to alter any 
decisions PSNC might make. 

PSNC's written response to 
both reports will be circulated for 
consideration well before the 
meeting. The closing date for 
resolutions is January 31. The 
conference agenda should be sent 
out early in February. 

PSNC challenges OFT 

PSNC has taken legal advice 
which suggests it may be 
exempt from aspects of the 
restrictive trade practices 
legislation. This would allow it 
to advise LPCs on pricing of 
pharmaceutical services. PSNC 
is awaiting the Office of Fair 
Trading's response. 

Pharmacy history 

The London School of Hygiene 
and Tropical Medicine is to 
conduct a two-year 
socio-historical study of British 
community pharmacy between 
1911 and 1986. Pharmacists 
wishing to contribute should 
write to the School's research 
fellow, Stuart Anderson. 

Price Service 

In the December 24/31 price 
supplement, the 'chesty 
cough' flavour (PIP Code 
012-3224) of the Hill's Balsam 
pastilles was shown in error as 
being deleted. We apologise 
for any inconvenience caused. 

MPs back ban 

Over 50 MPs have backed a 

parliamentary motion calling 
for Government to implement 
an immediate, nationwide ban 
on animal-tested cosmetics. 

Prescribing schemes 

There is a much confusion 
among non-fundholding GPs 
over the scope of prescribing 
incentive schemes, an NOP 
Research Group study of GPs 
reveals. One-third believe they 
cover all drugs across all 
therapies and one-fifth are 
unable to cite which disease 
area or drug categories are 

Pharmacies needed 

GPs' contractual obligation to 
issue NHS prescriptions rather 
than advise a cheaper, private 
or OTC alternative underlines 
the need for pharmaceutical 
services, especially in rural 
areas, says the Rural 
Pharmacists Association. 

GP purchasing 

The number of projects under 
which GPs purchase all 
hospital and community 
health services for patients 
will double to 50 in April. 

not consulted 
on FP10 

The Pharmaceutical Services 
Negotiating Committee has not 
been consulted on April's FP10 
re-design, and admits it has not 
seen any drafts of proposed 

"We will be pursuing the 
matter with the Department of ' 
Health, but it's probably unlikely 
we will be consulted in any 
depth," says PSNC's assistant 
secretary, Dr Gordon Geddes. 

Although the DoH is playing 
coy with what form the re-design 
will take, it is anticipated that all 
patients will have to sign the back 
of the form, indicating either 
their exempt status or con- 
firming script payment. "Is it to 
be signed in the same place? That 
will make it difficult to decide 
between chargeable and exempt," 
comments Dr Geddes. 

A DoH spokesman would only 
confirm that changes to the FP10 
are being "considered" and that 
an announcement will be made 
shortly. He could not say whether 
an April introduction is on the 
cards, but at an Audit Com- 
mission conference last week (see 
below), Mike Siswick of the NHS 
Executive announced: "We are 
now re-designing the back of the] 
form [FPIO] and will be in- 
troducing it in April." 

NHS workers fundamentally honest 

The majority of people working in 
the NHS are diligent and honest, 
was the message which came out 
of last week's Audit Commission 

"Proven fraud equates to lp 
per £100 spent, but that should 
not lead to complacency," said 
Brian Marsden, deputy director of 
finance at the NHS Executive, 
speaking at the conference — 

'Protecting the public purse: 
ensuring probity in primary 
health services'. 

"Control systems are weak, 
especially where it involves self- 
certification by the contractor," 
he added. The preferred option is 
for independent external audit by 
the Audit Commission. 

Philip Lobb, director of audit 
for the Prescription Pricing 

Authority, described the analysis 
of 47 cases of investigations} | 
carried out in 1993/94. Ten were 
for excessive urgent call-out fees, 
six for excessive prescribing, four 
for drugs for export or personal 
use, three for oxygen mileage, 
three for incorrect endorse-' 
ments, three for selling FP10s,| 
two for exemption declarations' 
and 16 for 'other' irregularities. 

Chemist & Druggist 28 JANUARY 1993 

use survey 

Pharmacy-specific programmes 
apart, accounting is the next 
most popular function for 
pharmacists' computers, says the 
National Pharmaceutical Assoc- 
iation, which has recently 
completed a survey into the 

The Association's question- 
naire asked a representative 
sample of NPA members what 
alternative uses they had for their 
computers, other than pharmacy 
operations. Answer options pro- 
vided on the questionnaire 
included accounting, database 
processing and the compiling of 

The Association conducted the 
survey with a view to reviewing 
its own computer product 

Although full results will only 
be available after the next Board 
meeting, the NPA says that over 
half of respondees said they used 
their computers for other, non- 
pharmacy work. NPA business 
services manager Trefor Williams 
says he was surprised that such a 
high number of respondees used 
their computers for alternative 



Feedback from pharmacists, 
following one and half months of 
self-audit of community phar- 
macies throughout England, has 
generally been positive, ac- 
cording to the Royal Phar- 
maceutical Society's audit fellow, 
David Pruce. 

The model for self-audit, which 
was released at the end of 
November (C&D October 15, 
p608), takes in nine areas of 
pharmacy activity: the dispensing 
process, written and verbal 
information with dispensed 
medicines, purchasing and stock 
control, guidance for relief 
pharmacists, premises and equip- 
ment, health promotion, dom- 
iciliary services, residential and 
nursing homes, and response to 

Although it is still too early to 
gauge the response from those 
who are already experienced in 
self-audit, initial feedback from 
newcomers to the scheme has 
been good. "They think it has 
been helpful," comments Mr 

The Department of Health is 
still discussing possible part- 
icipation in the self-audit process 
with both Scottish and Welsh 

Chemist & Druggist 28 JANUARY 1995 

A suitable 
case for 

supply and perceived expense 
will stop some people from 
taking mefloquine and either 
taking not so effective 
\ regimens, or playing Russian 
'l roulette by not taking anything 
at all. Mefloquine does require 
great care in its prescribing 
y« k but, it a full OTC prophylactic 
pack was produced, backed by a 
comprehensive pharmacists' 
training manual, then I would 
confidently assume the 
responsibility for its sale. 

The pharmacy is the natural 
source of travellers' advice and 
the availability of proper 
malarial prophylaxis is an 
essential component of that 
service. I am sure that, if the 
inquiry, advice and sale is 
made at a single visit, then 
most customers would take the 
recommended prophylaxis. 
Once the traveller is sent to the 
doctor for a prescription, 
perhaps armed with the 
knowledge of its cost, then 
second thoughts will set in and 
risks will be taken, which must 
increase the incidence of 
tourist-contracted malaria. 

I wonder whether the still 
uncollected private 
prescription I am holding for 
mefloquine tablets is a portent 
for the future. Soon 
mefloquine is to be the 
prophylactic anti-malarial of 
choice for 60 countries 
worldwide {C&D Prescription 
Specialities, January 21) at 
which point my only advice to 
inquiring travellers will be to 
see their doctor. 

I anticipate the medics will 
quickly get their act together 
and have pre-printed 
prescriptions for mefloquine, 
but this is a POM and so 
should only be prescribed 
individually after considering 
the proper balance of risk. 
Certainly, if the patient is 
pregnant, psychiatrically 
disturbed or subject to fits, it is 
contra-indicated. And then 
there is the cost. Even 
compared with chloroquine 
and proguanil it is expensive 
and, from the comments of 
customers over the last few 
months, they consider those 
extra pounds can be the straw 
that breaks the camel's back of 
an already expensive holiday. 
The combined difficulty of 

POM to P's 
power to 

There has seemed to be an 
explosion of drugs being 
deregulated from POM to P, 
and I am revelling in my 
new-found freedom to 
recommend products based on 
sound therapeutic principles. 
Some of the reclassifications 
have been accompanied by 
massive consumer advertising 
designed partly to usurp the 
pharmacist's intervention. But, 
whereas advertising is rarely 
sustained, I am always available 
to pour oil on the troubled 
waters of even the most 
excessive requests. 

Not all switches have lent 
themselves to these concerted 
advertising campaigns but have 
relied on the pharmacist's 
recommendation to build their 
market. When Buscopan was 
re-classified, I was pleased to 
have available another very 
useful drug. That confidence 

has been justified by many a 
grateful patient, and my sales 
have steadily climbed until my 
role has expanded to include 
the counselling of repeat users. 

This is the type of 
professional satisfaction I enjoy 
and, with the latest batch of 
changes recently announced, 
{C&D January 21, p80), I 
anticipate further movement 
towards this method of 
marketing. Given the right 
products, I know I can make 
them a success, and with every 
effective new treatment, the 
public's confidence in using 
community pharmacy as their 
first port of" call will increase. If 
in so doing, my reliance on 
counter medical sales increases 
against prescribed medicines, I 
will have few complaints! 

GSLs: to 
display or 
not ... 

I recently read about my own 
success from a rather unusual 
source. The article had been 
written by Crookes Healthcare 
and reproduced for The Asian, 
a magazine aimed at Asian 
independent retailers. The 
praise came in the 
acknowledgement that 51 per 
cent of respondents would now 
'ask their pharmacist' about 
their sore throat in preference 
to seeing their doctor. 

Praise indeed, but Crookes 
then proceeded to encourage 
its grocery readers to capitalise 
on this self-medication 
awareness and exploit the 
market by trading up to more 
medicinal products. 

It is always a revelation to 
read grocery-orientated 
magazines, and this article is 
probably no worse than similar 
contributions by other large 
OTC medicines manufacturers. 
But the lesson is glaringly 
obvious. If Crookes wishes to 
promote its GSL medicines in 
grocery, that is its privilege, 
but I do not have to display 
them when I am able to fill my 
shelves with P medicines and 
other products not found on 
supermarket shelves. I consider 
a vilification campaign against 
Crookes is totally unjustified 
but. when its rep next asks me 
why Strepsils have lost their 
prominence in my display, I 
will point him towards my 
nearest drug store competitor. 





NaltreXOne fOr Paracetamol 

American alcoholics 

Naltrexone, the narcotic anta- 
gonist, has been approved by the 
Food and Drug Administration in 
the US as a treatment for 
alcoholism as part of an 
appropriate management plan for 
the addiction. 

The drug, manufactured by 
DuPont Pharmaceuticals and 
marketed in the US as Revia, is 
said to reduce the pleasure and 
craving for alcohol resulting in 
significantly increased abstin- 
ence rates. 

Studies have found that 
patients treated with Revia were 
approximately twice as successful 
at abstaining as those treated 
with placebo. Of those patients 
who did relapse, almost twice as 
many of the placebo-treated 
patients returned to heavy 
drinking compared with Revia- 
treated drinkers. The company 
stresses that the drug is an 

adjunct to counselling and not a 
replacement for it. 

Revia, available in 50mg tab- 
lets, is recommended as a once- 
daily dosage for this indication. 

In the UK, naltrexone (Nal- 
orex) is licensed for maintenance 
therapy in detoxified heroin 
addicts. DuPont Pharmaceuticals 

in the UK says clinical studies are 
under way in Europe to support 
an application for marketing 
authorisation of the product as a 
treatment for alcoholism in 

An estimated 13.5 million 
Americans are afflicted by alcohol 
abuse or dependence. 

Too many ACE inhibitors? 

Three angiotensin-converting 
enzyme (ACE) inhibitors — 
captopril (Capoten), enalapril 
(Innovace) and lisinopril (Carace, 
Zestril) — should be enough to 
cover all indications, offering 
relatively simple regimens at 
acceptable cost, says the 
Consumers' Association in the 
latest Drug and Therapeutics 

Nine ACE inhibitors are 

available, but the report says that 
where comparisons can be made 
there is little to distinguish 
between them in terms of efficacy 
or safety. The others are: ramipril 
(Tritace), quinapril (Accupro), 
perindopril (Coversyl), cilazapril 
(Vascace), fosinopril (Staril) and 
trandolapril (Gopten, Odrik). 

ACE inhibitors are used in the 
treatment of heart failure and 

Good asthma management costs more 

A report on prescribing for 
asthma among general prac- 
titioners in London has found 
that good practice is associated 
with higher costs. 

Practices approved for voc- 
ational training, for band three 
health promotion, or for asthma 
surveillance, follow British Thor- 

Stelazine tablets 

The coating of Stelazine 
(trifluoperazine) tablets lmg and 
5mg has been changed from sugar 
to aqueous film, which results in a 
matt blue, instead of shiny blue, 
coating. Stnithkline Beecham 
Pharmaceuticals. Tel: 01707 

Asthma leaflets 

3M Health Care is now printing 
new markings — 'Reliever' and 
'Preventer' — on its asthma 
inhalers to help users distinguish 
between the two types. Although 
the two varieties are colour-coded, 
some patients are reported to still 
have difficulty differentiating 
between the two. The company has 
also produced a series of patient 
leaflets on asthma. The eight 
leaflets cover all aspects of asthma, 
including treatment, sport and 
trigger factors. Copies are available 


acic Society guidelines (higher 
level of prophylactic prescribing) 
for the management of asthma 
more closely than do other 
practices. They were found to 
have, on average, higher ratios of 
prophylactic to bronchodilator 
treatment. But they were also 
found to have higher asthma 

Script Specials 

from the company. 3M Health 
Care. Tel: 01509 611611. 

CSM lifts triangle 

The CSM has removed the 'black 
triangle' symbol from Smithkline 
Beecham's Seroxat (paroxetine), 
thus lifting the special reporting 
status imposed on all new products 
at their launch. Smithkline 
Beecham Pharmaceuticals. Tel: 
01707 325111. 

Fortijuice endorsed 

Fortijuice, the fruit-flavoured 
liquid nutritional supplement, is 
now available on prescription 
(endorsed ACBS) for patients with 
disease-related malnutrition. It 
contains hydrolysed milk protein 
and carbohydrates with added 
vitamins and differs from most 
supplements by being fat-free and 
not having a milk taste. Fortijuice 
is available in 200ml packs in three 
flavours, in cases of 30 (basic NHS 

drug costs than other practices. 

In conclusion, the authors 
suggest that pressure to reduce 
the costs of asthma prescribing 
may lead to a reduction in 
prophylactic treatment, running 
contrary to the BTS guidelines 
and possibly worsening the 
quality of asthma care. 

price, £45). Cow & Gate Nutricia 
Ltd. Tel: 01225 768381. 

Warfarin phase out 

Boehringer Ingelheim is 
experiencing difficulties with raw 
material supplies for its warfarin 
tablets. As a result, the supply of 1. 
3 and 5mg warfarin tablets will be 
phased out in the UK. Pharmacists 
can contact the medical 
information department at 
Boehringer Ingelheim Ltd. Tel: 
01344 741347. 


Ciba Pharmaceuticals has 
discontinued the following 
products: Monaspor (cefsulodin) lg 
x one vial and Lopresoretic 
(metoprolol tartrate lOOmg, 
chlorthalidone 12.5mg) tablets x 
56. The company has discontinued 
them because of falling demand. 
Ciba Pharmaceuticals. Tel: 01403 


The ready availability of para- 
cetamol and awareness of the 
dangers of overdose are the 
reasons paracetamol is the most 
commonly-used substance for 
deliberate self-poisoning, reports 
the British Medical Journal. 

Researchers at Oxford inter- 
viewing patients who had taken 
paracetamol overdoses say more 
than three-quarters of them 
knew that paracetamol overdose 
could cause death. 

This high awareness of the fatal 
potential of paracetamol is 
probably a reflection of extensive 
media coverage of the subject, say 
the authors of the report. They 
conclude that educating people 
about the dangers clearly does 
not deter them, but reducing 
pack sizes would probably be 
more useful in preventing death. 

care at a 

Palliative care has reached a 
crossroads in its development, 
with an evolution from the 
traditional hospices to integrated 
care and palliation at home. 

Speaking at the launch of 
Durogesic, the transdermal del- 
ivery system for fentanyl, spec- 
ialists in palliative care outlined 
the ongoing developments in the 

Professor Sam Ahmedzai, a 
professor of palliative medicine at 
the University of Sheffield, 
identified the growth areas in 
palliative care as symptom 
control, measurement of distress, 
quality of life evaluations and 
cost-effectiveness studies. He 
sees improved symptom control, 
through a more active approach, 
as one of the biggest challenges to j 
health professionals in this area. ! 

The palliative care team is very 
similar to the primary healthcare 
team, according to Dr Howard 
Marsh, a GP from Cardiff. He 
considers the GP to be the team I 
leader who is able to involve 1 
specialists, nursing staff, family, [ 
friends, chaplain and social 
services in the care of cancer 
patients, most of whom prefer to 
be treated at home. 

Dr Peter Barrett-Lee, a Cardiff 
consultant clinical oncologist, 
believes palliative care is no 
longer restricted to simple pain 
control but total patient care. 

Chemist & Druggist 28 JANUARY 1995 

r ™ 

All year round press advertising. In-store trials. Sample deliveries to new Mums. 

The support of midwives and health visitors everywhere. 
You'd be wise to put an order in now-this new baby's going to grow up very fast. 




Positive Health 

Seven Seas Limited, Marfleet, Hull HU9 5NJ. Telephone 01482 375234. 


Piles info 
& support 

A new information service 
for piles sufferers aims to 
alleviate the 

embarrassment associated 
with the condition. 

Preparation HELPS 
(Help and Educational 
Literature for Piles 
Sufferers), an initiative 
from Whitehall 
Laboratories, will publicise 
the incidence of piles, 
outline the options 
available and highlight the 
importance of a healthy 
lifestyle. It will provide 
educational literature and 
fund research. 

One-third of the 
population develop piles at 
some point in their lives. 
Only 10 per cent of 
sufferers seek advice 
immediately and 64 per 
cent only consult a CP or 
pharmacist when 
symptoms become too 

The service is available 
by writing to: Preparation 
HELPS, 227-229 
Chiswick High Road. 
London VV4 2DVV. Tel: 
0181 747 8797. 

Hill's hits 


The Hill's Balsam range 
hits the tabloids this 
month as part of a 
£250,000 advertising 

Running until 
mid-March, ads will appear 
in the Daily Express, Daily 
Mail, Daily Star, The Sun 
and Today, and will be 
seen by an estimated nine 
million readers every 
week. Windsor Healthcare. 
Tel: 01344 484448. 

Zantac available OTC 

The latest POM to P switch 
to he launched is Zantac 
75, an OTC presentation of 
Zantac (ranitidine), the 
market leading 
prescription product for 
acid-related disorders. 
Zantac 75 is the second 
Glaxo POM to P switch to 
be marketed by Warner 
Wellcome Consumer 
Healthcare (Beconase 
Hayfever was the first). 

Zantac 75 is licensed for 
the treatment of 
heartburn, dyspepsia and 
hyperacidity and is claimed 
to relieve symptoms for up 
lo nine hours. It has no 
known clinically- 
significant interactions 
with other medicines. 

The recommended dose 
tor adults and children 
over 16 is one tablet, 
swallowed whole with a 
drink of water, as soon as 
symptoms start. Another 
tablet can be taken if the 
symptoms recur to a 
maximum of four tablets 
in 24 hours. The 
maximum duration of 
therapy is two weeks and if 
symptoms persist, the 
patient should visit their 

Zantac 75 is available in 
packs of five or ten tablets, 
priced at £1.99 and £3.89 
respectively. The company 
believes the premium price 
is justified by the well 
established efficacy and 
safety of the product. A full 
margin of 33 per cent will 
be available to pharmacy 

Although Zantac 75 is 
the third H2 antagonist on 
the market, Warner 
Wellcome is confident that 
it has learned from the 
experiences of Smithkline 

Beecham and Centra 

The launch of Zantac 75 
is being supported by a £7 
million marketing 
programme with an 
"emphasis on education 
not promotion". It 
includes television and 
press advertising 
campaigns, an educational 
training package, public 
relations campaign and 
sales promotions. 

An 'acid-free' 
programme, prepared by a 
team of dietitians and 
nutritionists, is planned to 
run m all national media 
during 1995. It's aim is to 
encourage a more positive 
and healthier approach to 
diet and lifestyle with 
practical advice on daily 
diet planning. 

The range of 
professional and consumer 
support material will 
include information 
leaflets on indigestion, diet 
and lifestyle. Educational 
materia], designed 
specifically for the needs of 
the pharmacist and the 
pharmacy assistant, 

guidelines/protocols for 
the diagnosis of acid 
prescribing of H2 
antagonists, summary 
reference cards and 
manuals, and training 
videos and audio cassettes. 

The UK market for 
indigestion products is 
worth in the region of 
£70m and it has shown 
annual growth of over 22 
per cent, due in part to the 
launch of Tagamet 100 and 
Pepcid AC. 

Market research 
estimates that 
approximately 14 million 
people in the UK claim to 
have suffered indigestion 
in the last three months 
with nearly 2m suffering at 
least once a day. However, 
a small proportion of 
regular users account for 
the majority of the sales 
volume and around 44 per 
cent of sufferers are 
currently non-medicators. 

Warner Wellcome hopes 
the launch will expand the 
category and attract new 
users. Warner Wellcome 
Consumer Healthcare. Tel: 
01703 641400. 

For urinary discomfort 

Two new Medic Herb 
Biological Medicines are 
being introduced this 

Sabalin (60 tablets, 
£5.99) is for the 
symptomatic relief of 
short-term urinary 
discomfort in men. It 
contains Saw palmetto 
(dwarf palm) fruit extract 
(Fructus sahal serrulata) 
equivalent to 475mg. 

Uvacin (80 tablets, 
£5.99) is a traditional 
herbal remedy for the 
symptomatic relief of 

short-term female bladder 
discomfort. Its diuretic 
effect helps to flush out 
the urinary tract. Each 
tablet contains dandelion 
root extract equivalent to 
600mg. bearberry extract 
equivalent to 300mg and 
peppermint extract 
equivalent to 50mg. 

Both products will he 
supported by consumer 
advertising. They are free 
from animal ingredients, 
gluten-free and not tested 
on animals. Kallo Group 
Ltd. Tel: 01932 355303. 


Rhone-Poulenc Rorer is 
re-paying pharmacists' 
support for last year's 
Brol-eze launch with 
improved profit margins of 
33.4 per cent POR. or a 50 
per cent profit cost 
opportunity. The new 
standard trade margin 
comes into effect from 
March 1. "In recognition 
of the tremendous support 
we received last year from 
pharmacists we are 
delighted to offer a superb 
deaf for 1995." says RPR's 

Run rings 



Copper rings to 
complement existing 
copper bracelets have been 
introduced by Sabona ol 

The rings can he worn 
on their own or, says the 
company, in addition to a 
bracelet to increase the 
amount of copper the skin 
can absorb in the form of 
copper complexes. These 
are said to provide relief 
from rheumatic and 
arthritic aches and pains. 

The rings are available 
in adjustable sizes with 
three metal finishes: 
natural copper (£3.50 rsp), 
24-carat gold-plated, or 
24-carat gold-plated with a 
silver rhodium band 
(£9.99). Maddox Health & 
Beautv. Tel: 0181 795 





New packs of Anadin Extra 
now include the names of 
the active ingredients — 
aspirin and paracetamol — 
on the front, as well as on 
the back. Whitehall 
Laboratories. Tel: 01628 

Chemist & Druggist 28 JANUARY 1995 

category manager for 
eyecare Jeff Bulmer. 
Rhone-Poulenc Rorer Ltd. 
Tel: 01323 534000 


Rudolph the Reindeer. 

Rudolph the Reindeer. 

Forget your cold - get on with life! 

Rudolph the Reindeer. 

Forget your cold - get on with life! 

Rudolph the Reindeer. 

Adcock Ingram presents Lemplus. 
An effective new treatment for colds, 
flu and depressed profits. 

For customers who would prefer to forget the 
stuffy, red noses associated with colds and get 
on with life, there is now new Lemplus. 

New packaging means Lemplus capsules and 
powders stand out on your shelves. 

A complete, free promotional pack means 
they stand out in your pharmacy. 

Nationwide advertising in the Sun and Daily 
Mail means they stand out in your customers' 

And outstanding introductory trade offers 
mean Lemplus will do outstanding things for 
your profits. 

If you'd like to know more, please return 
the coupon. 

Please ask a Representative to call. 






Return to: Jim Ritchie, Adcock Ingram UK, 
FREEPOST (LE6362), Leicester LEI 7ZA. 



Adcock Ingram 

Forget your cold - get on with life! 

Legal status: GSL Active ingredients (powders): Paracetamol BP 
650mg, Ascorbic Acid BP 50mg. Active ingredients (capsules): 
Paracetamol BP 300mg, Caffeine BP 25mg, 
Phenylephrine Hydrochloride BP 5mg. 
Further information available from: Adcock Ingram UK, Premier 
House, 29 Rutland Street, Leicester LE I I RE 

On TV Next Week 

Prima's low-cost 
own-label range 

A chance to offer own-label 
food supplements without 
prohibitive start-up costs 
and long-term contracts is 
offered by Prima Health 

For a minimum initial 
order of about £250, 
pharmacists can obtain an 
own-label range of the 
most popular food 
supplements manufactured 
by a large multinational 
company. Products include 
evening primrose oil, cod 

liver oil, garlic, 
multivitamins and single 

After the initial order 
retailers can order any 
quantity they wish. 

The labels are flexible 
enough to allow space for 
product profiles and bat- 
coding as well as a product 
description. A special offer 
is running on evening 
primrose oil. Prima Health 
Products Ltd. Tel: 0161 
969 8948. 

No heartache for 

For Valentines worried 
that a romantic dinner for 
two might lead to 
heartburn, rather than 
true love, Keckitt & 
Colman is promoting its 
Heartburn Hot-Line once 

During the first three 
months of offering the 
Freephone service (0800 
556611), more than 500 
calls a week have been 

received and 200,000 
booklets — 'Taking the 
heat out of heartburn' — 
have been distributed to 

The service is being 
publicised through the 
women's press, national 
newspapers, local radio 
stations and doctors' 
surgeries. Reckitt & 
Colman Products. Tel: 
01482 26151. 

New Oruvail gel point of 
sale material and a display 
unit (now in outers of ten) 
are now available from local 
Rhone-Poulenc Rorer reps. 
This is to coincide with a 
new TV campaign which is 
designed to highlight the 
product's active ingredient, 
ending with the message: 
'The key to deep down relief 
is the ketoprofen'. 
Rhone-Poulenc Rorer 
Family Health Division. Tel: 
01323 721422 




Numark promotions for 
February include 
own-brand reductions and 
a £1.99 promotion. 

In the own-brand sector: 
Actif Ultra Press-On 
Towels in regular and 
super are down to £1.75 
rsp per pack, with retailers 
gaining 20 per cent 
discount; ibuprofen tablets 
feature in a 14 for 12 and 
five for four offer; and 
members placing orders of 
more than £150 on 
Numark dressings qualify 
for a 10 per cent discount. 

In addition, £1.99 price 
promotions are running 
on twin-packs of Kleenex 
for Men, Lynx Africa 
variants, Sensor Excel 
Razor and Vaseline 
Intensive Care Dry Skin. 
Numark Management Ltd. 
Tel: 01827 69269. 

Tixylix on 

Tixylix is currently on-air 
in a £800,000 TV campaign 
designed to attract 
first-time mothers of 
pre-school children. 

The ad features a young 
mum, cradling her 
sleeping daughter, 
speaking out to other 
mothers on the soothing 
properties of Tixylix and 
the benefits of seeking 
pharmacy advice. Intercare 
Products Ltd. Tel: 01734 


Seton Healthcare is 
backing Medised in the 
brand's biggest ever 
advertising campaign. 

The parenting press 
blitz pushes the message 
of Medised's cold relieving 
properties and its capacity 
to aid restful sleep. 

Pharmacy trade 
advertisements and trade 
promotions are also 
planned. Seton 
Healthcare. Tel: 0161 652 


Breger Gibson has 
launched a new range of 
disposable nappies, 
specifically targeted at the 
independent sector. 

Tendercare Ultra 
Boy/Girl Nappies are 
positioned to give a low 
retail price and higher 
margin than well known 

The nappies retail at 
£3.99 and are available in 
Midi, Maxi and Junior 
sizes. Breger Gibson Ltd. 
Tel: 01352 711171. 

up Baby 

A £2 million support 
package for Baby Savlon 
— which includes 
consumer press 
advertising — kicks off in 

The campaign aims to 
reach over 95 per cent of 
Baby Savlon's target 

The package is also 
included in the Bounty 
pack available to all new 
mothers. Baby Savlon 
nappy cream also has 
exclusivity with the 
Bounty professional 
service, ensuring a focused 
sampling opportunity. 
Zyma Healthcare. Tel: 
01306 742800. 

GTV Grampian 
B Border 

BSkyB British Sky 
C Central 

C4 Channel 4 
U Ulster 
C Granada 
A Anglia 
CAR Carlton 

CTV Channel Islands GMTV Breakfast 
LWT London Weekend Television 

STV Scotland (central 

Y Yorkshire 

HTV Wales & West 

M Meridian 

TT Tyne Tees 

W Westcountry 

Askit Capsules: 


Benylin Childrens/Coughs: 

All areas 

Benylin 4-Flu: 

All areas 

Colgate Bicarbonate of Soda: All areas 


All areas 


All areas except U & GMTV 

Durex Condoms: 


Halls Mentho-Lyptus: 

All areas 

Hedex Headcold: 


Just for Men shampoo/gel: 

All areas except CTV, LWT & GMTV 

Lil-lets applicator: 

All areas except B, CTV & GMTV 

Medinex Night Time Syrup: All areas 


STV, G, Y, C & TT 


All areas 

Nurofen Cold & Flu: 

All areas 

Olbas Oil & Pastilles: 

B, G, Y & TT 

Oruvail Gel: 

All areas except U, B, CTV & GMTV 

Polygrip Ultra: 

All areas 




All areas 

Sanatogen: All areas except Y, CTV, W, CAR, TT, C4 & GMTV 

Seabond denture fixative: 

B, G, HTV&W 


All areas except CTV, LWT & GMTV 

Seven Seas: 

G, Y, C, CAR, TT, C4 & GMTV 


All areas 

Slim Fast: 

All areas 


All areas 


All areas 

Wella Colour Mousse: All except GTV, B, G, CTV, LWT & TT 

A new £500,000 TV campaign for Medinex Night Time 
Syrup breaks next week. The 20-second animated 
commercial features the plight of a tired and restless moon 
with Medinex coming to the rescue. The tag line of the ad 
is that Medinex offers 'a better sleep for a brighter 
morning'. Whitehall Laboratories Ltd. Tel: 01628 669011 


Chemist & Druggist 28 JANUARY 1995 

PRODUCT INFORMATION: Presentation: Gelatin capsules containing an oil containing as active ingredients; Levnmenthol Ph Eur 35.55mg, ( Morburol B.P. 2.25nig, Tctpincoi B.P. 66.6mg, Thymol B.P. 3. 1 5mg. Puinili: 
Pine Oil B.P. 1980 103.05mg, Pine Oil Sylvestris 9mg. Uses: For the symptomatic relief of nasal congestion and colds in the head. Dosage and Administration: Adults and children over 3 month:.; carefully sprinkle tl 
contents onto bedding or material, avoiding the possibility of skin contact. Alternatively, add to a pint of hot water and inhale vapour freely. Centra-indications, Warnings, etc.: Katvol should not be used 
by patients who arc sensitive to any ol the ingredients. Not recommended for children itndei 3 months ol age. Avoid contact with eyes and prolonged contact with the .kin I )o not take inti n tally. Package |j S ^ 3S tStDti 
Quantities: Packs containing 10 or 20 capsules. RSP: Capsules 10s f 1 .69, Capsules 20s £3.09. Legal Category: GSL Product Licence Not PL 0327/5914. Crooks Healthcare Ltd, Nottingham NG2 3AA. 


All children need warmth and affection, but those 
with nasal congestion also need effective relief. 
That's what they get from Karvol. It allows them to 
breathe easily throughout the night, and it does so 
gently, as there's nothing to swallow or rub 
onto a child's chest. Simply dab the pre 

measured dose cm a handkerchief tied to the cot, and 
the natural vapours of pine, menthol and cinnamon 
effectively unblock stuffy noses. 

That means a good night's sleep tor children and their 
parents - and keeps Karvol in front as the most 
" recommended nasal decongestant tor children. 

Gently does it 



Organics moves 
into dandruff 

Organics, Elida Gibbs' hair 
care range which promises 
root nourishment, is 
tackling dandruff with the 
introduction of two new 

Dandruff Control 
Shampoo (200ml, £1.89) 
and Dandruff Control 2 in 
1 (200ml, £1.99) join the 
range in February 
supported bv a 
variant-specific £500,000 
advertising campaign. 
Trial sizes (£0.59) will also 
be available. 

Independents stocking 
Organics are also to 
benefit from a 
price-marked promotion. 
Bottles of shampoo and 
conditioner will be priced 
at £1.59 and 2 in Is at 
£1.69 (while stocks last). 
The new variants will be 
included in the offer. 
• Consumers who 
purchase packs of 
specially-marked Organics 

Intensive Replenishing 
Conditioner Tubes, 
Intensive Deep Repair 
Creme Pots and 
Strengthening Leave-in 
Serum Pumps will also be 
offered a money-back 
guarantee if they are not 
satisfied with the products. 
Elida Gibbs Ltd. Tel: 0171 
486 1200. 


TV personality Caron 
Keating is promoting 
Sweetex Granulated on 
special packs, featuring 
some of her favourite 

There are two recipes 
incorporating Sweetex 
Granulated on each pack. 
A signed message from the 
celebrity highlights the 
importance of a healthy 
diet which is low in sugar. 
Crookes Healthcare Ltd. 
Tel: 01159 507431. 


Yardley of London has 
several promotions over 
the next couple of months. 

During February, there 
is £0.50 off selected face 
make-up products plus a 
free powder brush with 
any purchase of Yardley 
foundation or face powder. 

In March the company 
is promoting its Tweed 
fragrance for Mother's Day 
with a special offer of a 
free box of Bendicks Mint 
Chocolates with every 
50ml parfum de toilette 
spray purchase (£11.95). 

In its Aromatherapy 
range, a weekend break at 
a health farm is up for 
grabs in a prize draw 
involving instant win 
labels on special bottles. 

Finally, Bond Street 
Perfumery, the new 
fragrance arm of Yardley, 
is running a special 
promotion on its So ...? 
perfume. With every 50ml 
perfume spray purchase, 
there is a free So ...? body 
spray (worth £1.99). 
Yardley of London. Tel: 
01268 522711. 

Added Cachet 

A special Cachet gift pack 
is available in time for 
Mother's Day (March 26). 

Comprising a 30ml 
Cachet eau de toilette and 
free full-size talc, the pack 
is worth £12.25, but has an 

rrp of £8.50. It comes with 
a matching gift tag. 

The gift pack is available 
in outers of 12 and is 
supported by a shelf edger. 
Network Management. Tel: 
01252 29911. 

for mums 

Potter & Moore is 
introducing a range of gift 
sets for Mother's Day. 

In its Luxury Toiletries 
range, there is a Potter & 
Moore gift bag containing 
foam bath (200ml), talc 
(KlOg) and soap (75g) 
which retails at £3.99. It is 
available in three 
fragrances (rose, chintz 
and peach botanical), each 
bag decorated with a 
co-ordinating ribbon. 

In its Essentials line, 
there are new twin-packs 
which comprise a foam 
bath essence (100ml) and a 
body moisturiser (100ml). 
Retailing at £2.99, they are 
available in four fruit 

Essentials Foaming Bath 
Seed Sachets are new to 
the range and are available 
in a display outer. Each 
contains 24 x 15g sachets 
(rsp £0.25). 

The Essence of the Plant 
range has two Mother's 
Day offerings: duo packs 
which contain a foam bath 
essence (100ml) and body 
balm (100ml) in Aromatic 
Spices and Botanical 
Herbs. The combination 
pack retails at £2.95. 
• Essence of the Plant 
Bath Flakes are now 
available in sachets of 25g, 
packaged in sixes with an 
rsp of £1.95. Potter & 
Moore Ltd. Tel: 01733 


Following last year's 
introduction of Elseve 
Care Mousse Non-Rinse 
Conditioner, L'Oreal is 
now extending the Elseve 
franchise to an Instant 
Non-Rinse Intensive 

The intensive variant is 
a cream gel and comes in 
three colour-coded 
versions: protein (purple) 
— to repair and protect 
damaged hair; jojoba 
(yellow) — to moisturise 
medium to long hair, 
adding sheen; and massoia 
(orange) — to nourish and 
moisturise dry or normal 
hair from within. 

L'Oreal says that 
counter units and displays 
are available. The 
introductory price is £2.29 
(regular price £2.69 from 
April 1) and promotional 
launch packs carry a £1 
cash-back offer. 

Press advertising 
totalling over £500,000 
will put three million 
sample sachets in spring 
issues of major women's 
magazines. L'Oreal. Tel: 
0171 937 5454. 

The magic of 

Heathcote & Ivory has 
added magnolia to its Pact 
range of bath products. 

With top notes of 
tangerine and star anise; a 
heart of orange blossom, 
rose and iris; and base 
notes of vanilla and amber, 
it is available as a 
moisturising bath oil in a 
boxed gift container (retail 
£5) and hand-blown glass 
bottles. The ring style 
bottle retails at £20 and 

the octagonal for £10. 

The company is also 
launching the Collectable 
Series to coincide with 
Valentine's and Mother's 
Days. It comprises three 
jewel-shaped bottles with a 
choice of foam bath (£5) or 
bath oil (£6) available in 
nuit d'amour, mountain 
spring and peach from the 
Pact range. Heathcote & 
Ivory Ltd. Tel: 0171 935 

Reaching a standard 
of Excellence 

L'Oreal is launching a new 
hair colorant for grey hair 
— or hair that has grown 
dull with time — that 
promises to protect too. 

The patented formula of 
Excellence Creme envelops 
every hair shaft, 
restructuring and 
renewing its strength, as 
well as giving long-lasting 
colour, says the company. 
It comes in 18 shades and 
uses a new Appli-Creme 
System which guarantees 
control of the mixing 
process and ease of 


It will be available 
nationally from 
mid-February at a 
recommended price of 

Its launch is to be 
backed by a £5 million 
promotional spend, 
including £3m on 
television. Below the line 
activity includes a £2 
introductory cash-back 
offer and a training 
programme for retail staff. 
L'Oreal. Tel: 0171 937 




The new men's fragrance 
from Spanish perfume 
house, Antonio Puig — 
Aqua Quorum — is the 
official fragrance of the 
1995 America's Cup sailing 

Aqua Quorum gives a 
sporty twist to the well 
established men's brand, 
Quorum. The fragrance 
itself has top notes of 
bergamot, grapefruit and 
artemisia and heart notes 
of ozone, marine elements, 
geranium and nutmeg oil. 
Base notes are sandalwood, 
oak moss, amber and 

On counter from May 
10, the range is priced 
from £13.95 to £21. The 
launch will be supported 

with a press advertising 
campaign which will 
include liquid samples on 
the page of selected men's 
magazines. Creative 
Fragrances Ltd. Tel: 0181 
391 4200. 


Hawaiian Mango 
Conditioner is a new 
addition to the Freeman 
Botanical hair care range. 

Mango has been blended 
with banana to restore 
shine, says the company. 
The addition of Hawaiian 
ginger moisturises and 
disentangles the hair. 

It complements the 
range's Hawaiian Ginger 
Shampoo and retails at 
£3.99 (473ml). Fragrant 
Memories. Tel: 01342 


Chemist & Druggist 28 JANUARY 1995 


Simply the Best for. . . 

Simply Telephone Jeanette Wharmby 0623 22494, Fax 0623 641218 
or return this coupon to ColourCare International 
PO Box 12 Burns Street, Mansfield, Notts NG18 5 PS 




All change 

Oxysept 1 Step has 
completed its livery update 
with the introduction of 
hlack boxes. 

The new packaging 
follows the change to 
black-labelled bottles last 
summer. Allergan Ltd. 
Tel: 01494 444722. 

Energy care 

A holistic approach to skin 
care comes courtesy of 
Energy Emulsion, which is 
said to raise the energy 
levels in skin, fighting 
ageing, dry, impure and 
flaky skin. Energy 
Emulsion is available as a 
75ml pack retailing at £24 
(introductory price £22). It 
is available direct from the 
manufacturer: Energy 
Cosmetic International. 
Tel: 01865 875552. 


Dermacort 0.1 per cent 
hydrocortisone cream is 
now licensed for use in the 
treatment of mild to 
moderate eczema. New 
packaging and point of 
sale material will soon be 
available and advertising 
in the women's press is 
also planned. Panpharma 
Ltd. Tel: 01494 766866. 

Hermesetas twins 

A year-long Hermesetas 
Gold Choice press 
campaign features twins to 
emphasise the product's 
advertising theme of 

Different sets of twins 
will appear in press 
advertisements under the 
headline: 'Close. But not as 
close as Hermesetas Gold 

Choice is to sugar.' 

One ad shows eight 
pairs of twins from a 
Solihull school where the 
headmistress is conducting 
a twins' survey with 
Hermesetas sponsorship. 

The £1 million package 
also includes sampling 
activities. Jenks Group. 
Tel: 01494 442446. 

Total TV 

Colgate Total is back on TV 
as part of a £3.9 million 
spend with two new 
30-second executions and 
two 10-second versions 
running from February 
until April. 

Colgate-Palmolive. Tel: 
01483 302222. 

Fast facts 2 

Part two of Dove 'Fast 
Facts' is due out in March. 
The first part of the 
Filofax-style guide to Dove 
for pharmacy assistants 
came out last May. The 
second section will 
concentrate on acne care. 
The Dove sales team will be 
distributing the guide to 
pharmacists and assistants, 
along with sample bars. 
Lever Brothers Ltd. Tel: 
0181 541 8200. 

Slim Faster 

There are two new additions 
to the Slim Fast range: a 
new Ready to Drink variant 
called coffee delight 
(retailing at an introductory 
price of £0.99) and a new 
six-pack Nutrition Bar, 
peanut butter crunch, 
retailing at £2.99. Sun 
Nutritional Inc. Tel: 01753 

Yardley fashion 

Yardley has two looks for its 
spring-summer cosmetic 
palette. Soft Days opts for 

pastels with a "soft rose 
glow", while Sultry Nights 
goes for Hollywood glamour 
with strong eyes and lips. 
Yardley of London. Tel: 
01268 522711. 

Bourjois pastels 

Bourjois has unveiled its 
spring/summer collection 
under the name 'Un Ete 
Pastel'. Colour themes are 
pink and grey with lashes 
enhanced with the 
reformulated Cil Intense 
Mascara in black or brown. 
The collection is available 
from March 20. Bourjois 
Ltd. Tel: 0171 287 3051. 

Spring affairs 

Rimmel's look for the new 
season is called a Spring 
Affair, which combines 
lilacs, heathers, warm pinks 
and pale ivorys. The 
collection is available from 
March. Rimmel 
International Ltd. Tel: 
01233 625076. 

NSB moves 

Distribution of Natural Sea 
Beauty has changed to: 
Chancellor Group Ltd, 
Wrexham Industrial Estate, 
Wrexham, Clywd LL13 
9PW. Tel: 01978 661351. 

Smint campaign 

Cedar Health is rolling out 
a £250,000 consumer push 
for its mini mint, Smint. 
Product sampling and 

extensive consumer PR will 
be followed by advertising 
in national titles later in the 
year, the company says. 
Cedar Health. Tel: 0161 
483 1235. 

New diaphragm 

Lamberts (Dalston) is 
launching Reflexions Flat 
Spring Diaphragm 
following the company's 
acquisition of the 
manufacturing rights from 
Durex. Lamberts (Dalston) 
Ltd. Tel: 01582 400711. 

Kenwood offer 

Kenwood is running an 
'added value' promotion on 
its range of water filters 
until the end of March. 
Special packs are available 
on the range of jug water 
filters which contain a free 
replacement cartridge 
(worth £2.99). A free 
cartridge is also offered on 
Kenwood's table-top 
electronic water filter 
(worth £6.99). Kenwood 
Appliances pic. Tel: 01705 

Primetex cloths 

A new range of cleaning 
cloths for industrial, 
hygiene, medical and 
general purpose use — 
called Primetex — has been 
launched by Shiloh 
Healthcare. Shiloh 
Healthcare. Tel: 0161 624 

■ . .. 

dm how many 
people in the UK risk 
heart disease because of 
excess cholesterol? 

you like a share of a growing 
multi-million pound market? 

MMifMMY when £4 million 

is being spent to launch 
a new solution from Ribena? 

See next issue. Wlio knows, it could do wonders for your financial health, too. 


Chemist & Druggist 28 JANUARY 1995j||j[ 

From a world of experience 

l ~~ — J <~ 

mm>- & 




One tablet calms and subdues excess stomach acid for up to 9 hours 

A new world 
of relief OTC 

♦ Zantac has been used 
for over I 3 years in 
more than 200 million 
patient treatments 

♦ Zantac has an 
unparalleled record 
of safety 1 and efficacy, 
with no clinically 
significant drug 
interactions 2,3 

♦ Zantac 75 is the 
pharmacists' brand of 
Zantac, the world's 
leading prescription 
medicine for acid- 
related disorders. 

♦ Zantac 75 is a logical 
successor to alginates 
and antacids for 
customers with 
heartburn, dyspepsia 
or hyperacidity. 

♦ Zantac 75 treats the 
root cause of the 
problem and lasts for 
up to 9 hours' 

♦ Zantac 75 is available 
in packs of 5 and I 

ranitidine 75 mg (as hydrochloride) 

A new world of relief OTC 

-.ssential information ZANTAC 75 ranitidine 75mg (as hydrochloride) Presentation Pink five-sided 
pantac 75 tablets each containing 75mg ranitidine (as hydrochloride) Uses For the short-term 
lymptomatic relief of dyspepsia, heartburn and hyperacidity Dosage and administration Adults and 

nildren aged / 6 years and oven one Zantac 75 tablet to be swallowed whole with a dnnk of water If 
ymptoms persist for more than one hour or return, another tablet may be taken. No more than 4 
ablets should be taken in any 24 hour penod Contra-indications Hypersensitivity to any component 
frecautions Treatment should be restncted to a maximum of two weeks' continuous use at any one 
me. Patients are advised to contact their doctor if their symptoms get worse or are no better after two 
weeks' continuous treatment with Zantac 75. Zantac 75 should not be taken by the following groups 
nless advised by a physician: patients under medical supervision for any other illness, patients with a 
previous history of peptic ulcer disease, patients who are 45 years or over with new 

I>mgQ\fn or recen tly changed dyspeptic symptoms, or if these symptoms are associated with 
an unintended weight loss, women who are pregnant, trying to become pregnant or 
antac 75 is a trade mark of the Glaxo Group of Companies 

breast-feeding Individuals wrth difficulty swallowing should consult their doctor Avoid in patients wrth a 
history of porphyna Drug interactions There are no clinically significant interactions wrth other drugs 
Side effects Generally well tolerated Rarely, headache, dizziness and allergic reactions have been 
reported Retail selling price Pack of 5 tablets - L I 99 Pack of 1 tablets - £3 89 Legal category P Date 
of preparation 3 95 Product licence number PL 10949/0223 Further information is available from the 
product licence holder Glaxo Pharmaceuticals UK Ltd. Stockley Park Middlesex UBl I IBT Distributed 
by Warner Wellcome Consumer Healthcare. References I Pension JG. WoTnsie. 'G S:;-r 
Gastrenterol 1989, 24 (9) I 145-1 152 2. Klotz U, Kroemer HK Pharmacol Ther 1991. 50: 233-244 
3. Mitchard M. Hams A, Mullmger BM Pharmacol Ther 
1 987. 32: 293-325 4. Data on file Glaxo Pharmaceuticals 
UK Ltd. 

Warner Wellcome 

A new world of und 

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• Then they produced a 
programme specifically to reflect 
your needs. 

♦ The Zantac 75 Pharmacy 
Education Programme is designed 
to help promote effective 
counter prescribing for you and 
your staff: 

- Opinion Leader video on 
H 2 -antagonists and their role OTC. 

- Pharmacists' Reference Manual. 

- Recommendation guideline 

- Counselling checklists for you 
and your staff. 

- Pharmacy Assistants' Training 
Video and Manual. 

A real 

♦ CI million support package for 
Zantac 75. 

♦ Heavyweight national Press and 
TV advertising. 

# Major Public Relations 

# In-store counter unit with 
integral consumer advice leaflet 
and special consumer symptom 
checklist to help make selling 

as simple as possible for you and 
your staff. 

• Full range of merchandising 




One tablet calms and subdues excess stomach acid for up to 9 hours 

ranitidine 75 mg (as hydrochloride) 

A new world of relief OTC 

standing and opportunity 




2 antac 

Essential information. ZANTAC 75 ranitidine 75mg (as 
hydrochloride) Presentation Pink, five-sided Zantac 75 
tablets each containing 75mg ranitidine (as hydrochloride). 
Uses For the short-term symptomatic relief of dyspepsia, 
iheartbum and hyperacidity. Dosage and administration Adults 
jond children aged / 6 years and over one Zantac 75 tablet to 
e swallowed whole with a drink of water If symptoms 
persist for more than one hour or return, another tablet may 
be taken. No more than 4 tablets should be taken in any 24 
hour period. Contra-indications Hypersensitivity to any 
component. Precautions Treatment should be restricted to a 
m maximum of two weeks' continuous 

w^M£b^f^\ use at an y one time Patients are 
mm m%mf\%J advised to contact their doctor if 

Zantac 75 is a trade mark of the Glaxo Group of Companies 

their symptoms get worse or are no better after two weeks' 
continuous treatment with Zantac 75. Zantac 75 should not 
be taken by the following groups unless advised by a physician: 
patients under medical supervision for any other illness, 
patients with a previous history of peptic ulcer disease, 
patients who are 45 years or over with new or recently 
changed dyspeptic symptoms, or if these symptoms are 
associated with an unintended weight loss; women who are 
pregnant, trying to become pregnant or breast-feeding 
Individuals with difficulty swallowing should consult their 
doctor Avoid in patients with a history of porphyria Drug 
interactions There are no clinically significant interactions with 
other drugs Side effects Generally well tolerated Rarely, 
headache, dizziness and allergic reactions have been reported 

Retail selling price Pack of 5 tablets - £ I 99. Pack of 10 
tablets - £3.89 Legal category P Date of preparation 3/1/95 
Product licence number PL 10949/0223 Further information 
is available from the product licence holder: Glaxo 
Pharmaceuticals UK Ltd, Stockley Paric, Middlesex UBI I IBT 
Distributed by Wamer Wellcome Consumer Healthcare 

Warner Wellcome 


the fax 

The handling of scripts 
through non-contract 

Eharmacies has not 
een in the news much 
since last autumn, but 
there are indications 
that the subject might 
be back on the agenda 
in the near future 

It's the small things that often 
irritate the most. The faxing of 
prescriptions falls into this 
category. Since the fax provides 
the link which allows easy 
transfer of prescriptions from 
non-contract pharmacies, this 
modern communication tool is 
a mixed blessing. 

The debate over transmitting 
prescriptions in this manner has 
raged in England and Wales for 
several years. In Scotland, 
where the practice first raised 
its head, prescription transfer 
was prohibited by regulation 
on April 1, 1991. The canny 
Scots quietly closed a regulatory 
loophole that has been causing 
grief south of the border ever 

The Royal Pharmaceutical 
Society uttered on the matter 
last in August, 1994. The law 
and ethics policy committee 
concluded that the handling of 
NHS prescriptions through 
non-contract pharmacies did 
not amount to unprofessional 

The decision did not go down 
well at all, with the exception 
of the pharmacy multiples that 
engage in the practice. The 
Boots' response was: "Boots 
believes patients or their 
representatives should be able 
to present their prescriptions at 
the pharmacy of their choice, 
provided, of course, the 
necessary professional 
standards are in place." 

The committee clearly 
recognised that the practice 
could undermine an FHSA's 
responsibility for limitation of 

contract, and could impact on 
moves towards a rational 
location of pharmacies. 

Significantly, it took note of 
advice that any attempt to 
control competition by means 
of ethical rules would not 
withstand legal challenge. 

This has suggested to some 
pharmacists that the Society is 
running scared of the legal 
clout of the large multiples. 'If 
it was just a small independent, 
they would have stopped it' is a 
common refrain. 

Credibility gap 

Council's credibility with many 
community pharmacists has 
been badly dented, since it is no 
longer seen to be capable of 
enforcing their professional and 
ethical wishes. 

In its defence, Council has 
made it clear that while 
prescription transfer might be 
legal under the present NHS 
regulations, it does not mean it 
is Council policy. 

Senior Council member Bill 
Darling says his first wish for 
1995 is that the Government 
will act to ban non-contract 
pharmacies participating in NHS 

Despite the Society's concern, 
and pressure from the National 
Pharmaceutical Association and, 
more properly, the PSNC (since 
this is essentially a contractual 
matter), the Department of 
Health has so far refused to 
amend the regulations. 

The NPA argues that not only 
does passing prescriptions from 
non-contract to contract 

pharmacies undermine the 
intent of the control of entry 
regulations, it will encourage 
companies to move scripts to 
NHS pharmacies with item 
numbers bordering on the 
practice allowance threshold. 

This will become more 
important as the share of the 
global allowance apportioned 
to the professional allowance 
increases, although there is no 
evidence that it is happening at 
the moment. 

PSNC continues to lobby hard 
against non-contract 
pharmacies. Secretary Stephen 
Axon says a simple change in 
secondary legislation is all that 
is required, similar to that 
enacted in Scotland. 

He also makes the point that 
the situation does not give 
FHSAs a very good impression 
of the profession. "Some FHSAs 
think it is crazy although others 
take a more laid-back view." 
His one consolation is that he 
does not have to square the 
ethics of the matter. 

Right timing 

Despite the DoH's reluctance to 
legislate or make piecemeal 
changes to the regulations, the 
health minister, Gerald Malone, 
has indicated he will look at the 
matter when the time is right. 

The right time might be as 
soon as April, when the NHS 
(Pharmaceutical Services) 
Regulations 1992 will have to 
be amended to allow for part 
of the global sum to be 
devolved to FHSAs to pay for 
locally negotiated services. 

In a letter sent to PSNC dated 
January 9, Mr Malone says: "I 
am aware of the considerable 
strength of feeling within the 
profession about the issue and I 
can assure you that I will bear 
your concerns in mind if 
changes are being made 
relating to control of entry. I 
am replying in similar terms to 
Mr Ferguson, secretary and 
registrar of the Royal 
Pharmaceutical Society ..." 
Despite the brouhaha about 
pharmacies, a PSNC 
survey this week (see 
News) shows there are 
only around 40 outlets 
involved in script 
transfer. The practice at 
this stage is not so well 
established that it 
cannot be stopped. 

That might not be the 
case in a year's time. The 
message to the 
Department must be 
that if it is going to act, 
it must do so soon. 

There are also 
renewed stirrings 
^^^^ among the body of 

community pharmacists. 
London pharmacist 
Ashwin Tanna stuck his 
head above the parapet 
just before Christmas in 
a letter to the 
pharmaceutical press, 
and is seeking to 
re-open the debate in 
the Society Council 

He understands his 
concerns will be raised 
at the next meeting of 
the Society's law and 
ethics policy committee. 
Mr Tanna believes the 
Council's position — that the 
handling of NHS scripts by 
non-contract pharmacies does 
not amount to professional 
misconduct — is irrational. It 
could be subject to legal 
challenge, he says. 

Council has opposed the sale 
of lottery tickets from 
pharmacies on the grounds that 
it may prevent the prompt 
dispensing of prescriptions. At a 
non-contract pharmacy a 
patient may have to wait for 
several hours until the 
dispensed medicine is delivered. 

However, if Mr Tanna cannot 
persuade the Council to reverse 
its decision on the transfer of 
scripts, he will not take the 
matter further on his own: he 
cannot afford it. 

Should the Society's decision 
be subject to judicial review 
(and this is by no means 
certain), he says it is up to the 
membership to decide whether 
to proceed, and to help out 
with the costs. 

The ridiculous thing about 
the transfer of scripts is that 
there is so little to be gained 
from it. The patient is misled as 
to the nature of the outlet he is 
visiting, and will have to wait 
longer for his script. 

Because the dispensed item 
has to be delivered, it becomes 
less profitable (if at all) to the 
dispensing branch. And since it 
takes NHS dispensing business 
away from the local NHS 
contractor, it damages his 
viability at a time when profit 
margins continue to suffer. 


Chemist & 

Druggist 28 JANUARY 1995 


H c 45 is now available over the counter for mild 

to moderate eczema, which is good news tor 

customers who suffer from this condition. 

This pleasant non-greasy cream reduces the 

swelling and redness of irritated and itchy skin, 

soothes and calms the soreness while helping to heal. 

The leading emollient tor over 40 years, Cream 
E4^ replaces lost moisture in the skin, lubricating 

P 2 

an< J restoring the skin's flexibility. You should 

recommend it fur daily management, in the dry 
stages of eczema - and also to help reduce 
associated itching and provide extra soothing relief 

Not only is H c 45 excellent in its own fight, but it is >JCCi during flare-ups, between the applications of H c 45 

supported by a complete range of proven emollients, 

including Cream E 4 5 - and 

emollient therapy is the essential 

foundation of day-to-day eczema 


Of course, when eczema is severe, you should stil 

refer to a doctor. But otherwise you 

can confidently recommend the 


de atological cream 


complementary eczema treatment only 

E45 and H c 45 provide. 

RODUCT INFORMATION: H<-'45: Smooth white cream containing hydrocortisone acetate 
r 1% w/w. Uses: For the relief of mild to modetate eczema, irritant contact dermatitis, allergic 
|ontact dermatitis and insect bite reactions. Dosage and administration: Apply sparingly to a 
1 area, once or twice a day, for a maximum of 7 days. Contra-indications, warnings etc: H c 45 
hould not he used on the eyes or face, the ano-genital area or on broken or infected skin, including 
npetigo, cold sores, acne or athlete's foot. The product should not be used in pregnancy or in 
hildren under 10 years without medical advice. Package quantity: Tube containing 15g. 
'>SP: 12.49. Legal category: P. Product licence number: PL 0327/0039. Date of 
reparation: December, 1994. Cream E45: White bland emollient cteam which contains 

white soft paraffin BP 14.5% w/w. light liquid paraffin Ph Eur 12.6% w/w and hypoallergenic 
anhydrous lanolin 1.0% w/w. Uses: For the symptomatic relief of dry skin conditions, where the 
use of an emollient is indicated, such as flaking, chapped skin, ichthyosis, traumatic dermatitis, 
sunburn, the dry stage of eczema and certain dry cases of psoriasis. Dosage and administration: 
Apply to the affected part two or three time- daily. Contra-indications, warnings etc: Cream E45 
should not be used bv patients who are sensitive to any of the ingredients. Package quantities: 
Tubes containing 50g. Tubs containing 1 2 5 g and also 500g. RSP: Tube 50g £1.70. Tub 125g 
£3.45. Tub 500g £8.10. Legal category: GSL. Product licence number: PL 0327/5904. 
Crookes Healthcate Ltd. Nottingham NG2 3AA. Date of preparation: July. 1994. 


The proven power of ibuprofen. The established power of codeine. By bringing their; 
together in a unique combination, new Nurofen Plus gives you an ideal recommendation 
when extra-strength pain relief is called for: migraine, tension headache, cramping periocjj 
pain, post-operative dental pain, neuralgia, sciatica, lumbago and rheumatic pain. 


24 Tablets 


Jurofen Plus. Ibuprofen BP. Codeine Phosphate BP. 

roduct Information: Each tablet contains ibuprofen BP 200mg and codeine phosphate BP 1 2 5mg Indications: Effective in the relief of migraine, headaches, neuralgia, dental pain, dysmenorrhea, rheumatic 
id muscular pain, backache, fevenshness, symptoms of cold and influenza. Dosage and Administration: Adults and children over 12 years' initial dose 2 tablets taken with water, then, if necessary. I 
tablets every 4-6 hours. Do not exceed 6 tablets in 24 hours Precautions and Warnings: As with some other pain relievers, Nurofen f ot be taken by patients with a stomach ulcer or other 

pmach disorders or hypersensitivity to ibuprofen or codeine Patients receiving regular medication, asthmatics, anyone allergic to aspmn, and pregnant women should be advised to consult 
eir doctor before taking Nurofen Plus. In normal use, side effects are very rare, but may occasionally include dyspepsia, gastrointestinal intolerance and bleeding, constipation, nausea, skin 
Ishes, depending on dosage and individual susceptibility Not recommended for children under 1 2 If symptoms persist for more than 7 days, patients should be advised to consult their doctor 
roduct Licence Number: PLO327/O082 Licence Holder: Crookes Healthcare Ltd. Nottingham NG2 3AA Legal Status: P Price: I2's £1 85; 24's £3 39 Date: January 1995 


Small changes, 
big benefits 

Major refits once 
every five to ten 
years may be fine if 
you run a 

mega-pharmacy. But 
what if you've little 
floor space to play 
with, a business that 
isn't necessarily 
booming and the 
budget is tight. 
Pharmacy consultant 
John Kerry looks at 
how you can 
accentuate the 
positive by investing 
a little in point of 
sale aids, signs and a 
touch of corporate 

Community pharmacists, 
without exception, want 
customers to purchase more 
when they visit their shops. 
Patients for whom the 
pharmacy is just a facility for 
prescriptions are one of the 
most important customer 
groups, one which can be 
encouraged to shop. 

In my work with pharmacies, I 
have seen a number of simple 
pieces of equipment used, not 
only to communicate effectively 
with customers but also to 
improve the look of the front 

Script counter 

The prescription counter is the 
focal point in most pharmacies 
and is becoming both a 
customer medical information 
point and a consulting area. 
Three items will improve it. 

• Pinboard for notices and 
posters from both health 
authorities and medicine 
companies, such as: seasonal 
complaints; treatments, plus 
essential immunisation; holiday 
needs; and healthcare posters. 
These can be displayed 
together on one fitment. 

• Leaflet rack. Information 
leaflets from health authorities, 
specialist associations, hospitals, 
complementary medicine 
companies, pharmaceutical 
companies and local healthcare 
groups are on the increase. I 
counted more than 30 different 
types in a pharmacy recently. 
Typically, they were either 

... can transform your pharmacy 

spread untidily on the counter, 
tucked between products or 
piled on shelves. 

These leaflets not only serve 
as an important source of 
healthcare information, but 
also help to explain and sell 
healthcare products. 

Several types of leaflet racks 
are available. The least 
expensive ones, made from 
wire, serve the purpose, but 
tend to deteriorate quickly and 
look cheap. Moulded, clear 

styrene and Perspex types cost 
more, but look better and last 
longer. Unfortunately, they are 
only made in banks of four at 
most, therefore to 
accommodate three or four 
dozen leaflets will require up to 
a dozen multiple holders, 
screwed to a wall or screen. 

Now on the market, but not 
yet readily available from the 
usual sources, are leaflet racks 
made of enamelled, mild steel 
plate with adjustable plastic 

sliders to hold both one-third- 
sized A4 and A5 leaflets, and up 
to 40 different types. 

• Display cabinet. Too often 
high demand P medicines are 
inadequately displayed on 
shelving behind the counter or 
concealed in drawers. A display 
cabinet, on the medicines 
counter, presents '?' medicines 
securely close to, and at, 
eye-level. The cabinet should be 
the largest that you can 
accommodate without 
impeding vision or service. 

Pharmacists who employ 
these fittings tell me that they 
earn more than any two 
full-height shelf fixtures. The 
valuable space in the cabinets 
should be used for TV 
advertised and fast-moving 
seasonal 'P' medicines only. 

POS aids 

Fitments resembling library 
shelves crammed with products 
are a turn-off to customers. The 
most effective merchandising 
aids that I've seen are also the 
easiest to obtain. 

• Shelf barkers are holders that 
clip over the shelf or into the 
price ticket profile. They serve 
to attract attention to new 
products or those being 
promoted. Some pharmacies 
use these to excess and the 
purpose is lost, so it is advisable 
to limit them to one or two per 
unit for best effect. 

• Department/direction signs. 
Larger shops or those that are 
awkward in shape can be 
confusing to customers. This 
problem can be largely 
alleviated by the use of well 
sited department signs and/or 
direction signs. 

If customers know where to 
locate the products they're 
looking for, they are more 
likely to pick them up. 

• On-shelf displays. Take a leaf 
from the big stores' book and 
reserve a couple of areas for 
on-shelf displays rather than for 
tightly-packed product 

The most effective ones that 
I've noticed employ the same 
items used for window display 
— boxes, satins, dried flowers 
and other props. They need not 
be huge but, providing that 
they are well lit, can break up 
the monotony and attract 
customers' attention to the 

• Gondola end promotion. One 

of the most useful fitments in 
my experience is the gondola 
end promotion. Use this space 
for up to six monthly offers, 
multiple-faced, all with barker 
fitments or cards. If at all 
possible, face these towards the 
front door to draw passing 

• Dump bins are much 
maligned and abused. 
Manufacturers supplying them 
for major promotions often 
create the false impression that 
the contents are cheaper, when 
they are not. Dump bins should 
be employed only for stock 
clearance and really deep 
cut-price lines. Used sparingly in 
this way, they soon become a 

Only the best ... 

The right fitments for 
merchandise are essential for 


Chemist & Druggist 28 JANUARY 1995 

The NPA does the 

The National Pharmaceutical Association, among its many services, 
offers members a variety of display and sales aids. Gemma Collins 
of Business Services reviews some pharmacy favourites 

Small items are best merchandised 
in bins or baskets 

Dump bins should be reserved for 
very special price promotions only 

displaying products correctly. 
Too often I've seen everything 
for sale — including baby 
clothes, razor blades ana 
bagged goods — lying flat and 
almost invisible on shelves. By 
employing hook bars for all 
hanging and bagged goods, 
and sloping bins for small items 
and boxed tubes, your products 
will be seen as they were 
intended be. 

Loose and unpackaged 
goods, such as small soaps, look 
much better in baskets or 

Corporate style 

In my opinion, the pharmacies 
that look most professional and 
more interested in business are 
those which adopt a corporate 
style of their own, from the 
main shop sign and window 
graphics through to the 
internal colour scheme of the 

Price tickets, barker cards, 
internal signs and promotional 
posters in the same livery and, 
where appropriate, with the 
shop logo, add a pleasing 
finishing touch to an attractive 

On average our department 
sends pharmacists more than 
1,000 items a week, ranging 
from practice leaflets to 
Electrolux pharmacy fridges, all 
featured in the NPA Directory. 
Some can make the running of 
a successful pharmacy business 
a more profitable and 
hassle-free experience. 

Here are just a few of the 
more popular lines, not in any 
order of priority or preference: 

• CCTV — closed circuit 
television is a sensible way to 
make sure all your 'sales' go 
through the till. More inquiries 
than ever are coming through 
the department at the moment 
for kits that range in price from 
£85 for a single, static simulated 
camera with a flashing light, to 
a black and white monitor with 
single camera and all fitments at 
£359 (additional cameras £195). 

• Convex security mirrors — 
mirrors are an alternative and 
cheaper fly on the wall than TV 
cameras but, like the TV 
monitors they can substitute, 
they need to be looked at 
constantly to be effective! 

Prices range from £61 for a 
standard 24in mirror on a 
swivel arm to £84 for a slim- 
view variant with orange trim. 

• Display stands — these come 
in all shapes and sizes, and 
range from single dump bins to 
revolving multiple bin units 
carrying up to nine separate 
baskets. These are ideal for 
showing off pharmacy sundries 
or 'this week's special offer'. 

• Price tickets/shelf barkers — 
the latest systems enable 
pharmacists to produce 

A low-cost closed circuit TV 
package has been launched by 
Philips Communication and 
Security Systems. 

Philips claims its VSS 2285 
Observation System is easy to 
install and operate and is 
ideally suited to retail 
applications. It includes a 
monochrome camera with wide 
angle lens, mounting bracket, 
25m of standard cable and a 
1 2 i n monitor. 

The camera may be sited up 
to 200m away from the monitor 
— 400m with an extension — 
and the system is suitable for 
self- or specialist-installation. 

The VVS 2285 can handle up 
to four cameras with manual or 
automatic camera sequencing. 
Slave monitors are an added 
option, as is an audio intercom; 
and an alarm trigger system, 
such as an infra red, door 
detector or a pressure mat. 
Philips C&SS. Tel: 01223 245191. 

personalised labels in-store to 
supplement those supplied by 
manufacturers or wholesalers. 
We have various computer 
software packages to link with 
laser or dot matrix printers. 

Bespoke labels can make your 
pharmacy stand out from the 
crowd. One system can produce 
anything from a shelf barker to 
A5 sales messages and A4 posters. 

• Signage — smart, bright signs 
showing clear messages add to 
the professionalism of a 
pharmacy interior. They can 
range from hanging neon 
'prescriptions' signs at £350-plus 
to laser-printed acrylic versions, 
top-lit by strip lights, from 
under £100. 

• Display panels — these can 
be particularly useful in a 
window for customised 
messages. Ready-made kits start 
at £125; others can be delivered 
to pharmacy specifications and 
are equally effective as in-store 
information centres. 
Pharmacists have shown a lot of 
interest in these recently. 

• Leaflet displays — pharmacies 
have an increasing number of 
healthcare leaflets to display. 
The introduction of the 
Professional Allowance and the 
conditions for its payments has 
made adequate leaflet display 
facilities even more important. 

The NPA has a variety of 
stands on offer, ranging from 
four-slot, acrylic counter-top 
units at £7.10 to a 12-slot unit 
at £26 (both one-third A4 size). 

Free-standing spinner stands 
taking more than 30 leaflets 
cost just over £40, while a 
wallframe with 11 pockets and 

Business Services 

Business Services comprises 
two separate operations — 
marketing and sales. The 
marketing arm constantly 
sources and promotes 
products. Sales handles the 
1,000-plus orders per week, 
along with hundreds of 

A new delivery system 
means orders are dispatched 
and delivered within 48 hours; 
delivery is guaranteed in that 
time and the goods are 

Since September last year, 
the Association has included 
in the NPA Directory its 
complete range of products 
and prices, training services, 
information leaflets, and PR 
and publicity services. 

Details from Business 
Services on 01727 858687 ext 

header card comes in at around 
£17 — both in poly-coated wire. 
• Forgery detectors — finally, a 
little tool that can ensure the 
bank notes customers hand 
over will be accepted at the 
bank ... The detector pen has 
replaced the UV detector as the 
weapon of choice in small 
businesses. At around £3, the 
pens are used to mark notes as 
they are handed over; if the 
mark stays clear or light amber, 
then the note is genuine, if it 
appears as dark blue or brown, 
the note is suspect. Detector 
pens were flavour of the month 
in the run-up to Christmas! 

New closed circuit TV from Philips 

The new low-cost Philips' CCTV system aims to cut crime 

Chemist & Druggist 28 JANUARY 1995 


Saveker screens 
for better 

T Saveker has launched a screen 
system which is said to provide 
unobtrusive yet effective 
protection from physical attack. 

Concealed fixings fit the 
etched and silver-anodised 
aluminium standard sections 
together. Saveker says awkward 
corners and heights can be 
accommodated. T Saveker. Tel: 
0121 359 5891. 

Starter CCTV retail 
pharmacy system 

The Retail Starter CCTV System 
from Sensormatic is available in 
three options, costing from less 
than £10 per week, but 
featuring 'operational 
sophistication' associated with 
more expensive packages. 
Colour Option 1 includes an 

advanced 330-line CCD camera 
with auto white balance, 
electronic shutter for operation 
at 1.8 lux, together with 14in 
monitor and all brackets. 

Option 2 has two cameras, 
and a two-way switcher, while 
Option 3 features three 

cameras and four-way 
switching. Both have automatic 
or manual camera sequencing. 

The company has produced a 
guide to its Ultramax retail 
security tagging system and 
security systems in general. 
Sensormatic. Tel: 01442 231678. 

A Saveker cashpoint-style protection screen 

Oldham's new fascia signs 

Oldham Signs is developing a 
new range of standardised 
fascia box signs in co-operation 
with the National 
Pharmaceutical Association. 

There will be three colour 
and three typeface options 
manufactured in illuminating or 
non-illuminating formats, 
according to customer 

preference, cost and planning 

A brochure will be available 
shortly from: Oldham Signs. Tel: 
01532 404142. 

Oldham's new design features an aluminium box frame and Opal 050 white Perspex. At 400 x 90cm, text is 
visible from 200 yards at night 

POS units 
the key? 

If you have some stock that is 
not moving, then British 
Turntable could provide the 
solution ... 

Working on the principle that 
movement attracts, the 
company has extended its 
range of POS items to include 
small turntables and rocker 

British Turntable can also 
supply turntable bearings and 
"other movement options" to 
order, and can be consulted on 
cost-effective display solutions. 
For the new colour POS 
brochure phone: British 
Turntable. Tel: 01204 525626. 

lighter side 

Micromark can supply various 
types of shop lighting, 
including spotlights, nalogen 
floor-standing uplighters and 
security lights. 

Details of the range are 
available at Lightshow '95, 
stand B23 at Earls Court on 
January 29-February 1 or from: 
Micromark. Tel: 0181 881 2001. 

Chiltern's cash 
till clamp 

Chiltern has launched a clamp 
of welded steel, with a stainless 
steel or epoxy-coated finish, 
that will secure a flip-top cash 
cassette till to its mounting and 
prevent the forcing of the lid. 

The brace has a ten-pin radial 
lock and costs £45 per unit with 
p&p extra. Chiltern Retail 
Systems. Tel: 01525 374619. 

Shopfitting and mini-lab 

Leicester-based City Design 
specialises in mini- fab 
installations within existing 
retail operations, but also offers 
a design and manufacturing 
service for fitting out the whole 
The company has 30 years 


experience in the retail interiors 
field and has recently worked 
on several Pharmacy Film 
Centres in conjunction with 
both Gretag and Kodak, pro- 
ducing in-shop and stand-alone 
mini-lab installations. City 
Design. Tel: 01455 250550. 

Baxall takes command 

Baxall Security has launched an 
automatic pan and zoom CCTV 
system with features "usually 
associated with major security 

The key is the new ZR4 mini 
telemetry receiver measuring 12 
x 10cm, which fits into the 
camera housing to link, via 
existing cabling, with the 

The operator has full control 
over pan, tilt, zoom, focus, etc 
and can command 'washing, 
wiping and floodlighting' at 
the touch of a button. Also 
eight pre-set camera positions 
can react to a security or fire 

For technical literature 
contact: Baxall Security. Tel: 
0161 406 6611. 

Chemist & Druggist 28 JANUARY 1 995 

NEW Pripsen Mebendazole Tablets 

Mebendazole USP lOOmg 

Threadworms arc a common complaint and customers rely on you to 
recommend a complete and effective treatment. 

New Pripsen Mebendazole Tablets are the only Double Dose treatment 
presented as two chewable tablets, each containing LOOmg Mebendazole. The 
First dose kills the threadworms; the second, to be taken 1 i days later if 
reinfection occurs, kills any threadworms produced from residual eggs. 

W ith an RSP of £1.89, Pripsen Mebendazole Tablets offer your customers 
the reassurance of a complete effective treatment in one value for money pack - 
with the excellent profit margins you'd expect from Seton. 

Pripsen Piperazine Phosphate powder has been tried and trusted for over 

20 years and is still available on prescription and for OTC recommendation. 


Make sure you talk to your Seton representative about special Pripsen deals. MMM Healthcare Group pic 

Presentation: < hewable orange flavoured off-white tablets containing Mebendazole i SP lOOmg Uses: h >r the treatment of Threadworm i Enterobiasis) infestation Dosage and Administration: \dults & 
Children i >ver 1 years - Dose I tablet to be chewed or swallowed with water Tin di ise to he followed In .1 second tablet I t da} s later, it reinfestation "(.oil's Not suitable fi >r children under 1 
years Contra-indications, Warnings etc: < ontra indications: Mebendazole has not been studied extensiveh in children under two \c.irs of age - !"r ihis reason 11 is not current!) recommended for 
children under two vc.irs ol age Other undesirable effects: Side-effects reported have been minor Transient abdominal pain and diarrhi lea have been reported on!) r.ircb in c.isc-s , it massive infestatii in 
and expulsion oi worms i sh^ln headache and dizziness have been occasional!) reported 1 Use in Pregnane) and lactation: since there is .1 risk that Mebendazole could produce foetal damage if taken 
during pregnane) it is contra-indicated in pregnant women No information on secretion into milk is available so mothers taking the dru-a should not teed Other special Warnings and 
Precautions: It after two weeks you need to take the second tablet following which your symptoms persist then consult your doctor Overdosage: No cases of overdose have so tar been reported with 
Mebendazole, hut gastric lavage and/or supportive measures would he recommended S) mptoms ol acute overdosage would be expected to include gastrointestinal disturbances abdominal pain headache 
dizziness pv rcxi.i and 1 onv ulsions Pita Precautions: store .it or below 2 s t in -i v!r\ place Legal status: P Packs: Blisters 1 >l - Tablets Price: R s p ,1 ] so Product Licence Number: PI 
0J38/0084 Product Licence Holder: Cupal ltd Distributor: Seton Healthcare Group pic fubiton House Oldham till -ills England Telephone (0161)652 2222 Date of Revision: November 1994 








Managed care 

In the second of a series of articles looking at pharmacy in the US, 
John Donohue examines developments in health purchasing as they 
affect American community-based pharmacists 

Health management, or 
managed care, is a boom 
industry in the US. The basic 
unit in managed care is the 
Health Maintenance 
Organisation. Clients of the 
HMO are usually large bodies, 
like trades unions, insurance 
companies and employers, who 
want to offer health benefits, 
but lack the skills or resources 
to provide them. 

They will contract with the 
HMO to provide the health 
benefits, and the HMOs then 
contract with health providers 
— doctors, pharmacists, 
dentists, hospitals and so on — 
to provide services directly to 

This role is not dissimilar from 
health purchasing in the UK. 
However, the differences 
become apparent when you 
realise that the HMO will not 
necessarily contract with every 
doctor or pharmacist in a given 
area, and this injects an 
element of competition and 
power into the purchaser/ 
provider relationship. 

For example, for pharmacists, 
there may be competition 
around dispensing fees, or 
additional services may be 
specified, such as counselling 
and information, to be given to 

Pharmacy input 

Pharmacists are involved with 
HMOs in a variety of ways. 

There will usually be 
pharmaceutical advisers 
working within the HMO, 
similar to FHSA advisers. HMOs 
will also contract with 
consultant pharmacists to 
provide Drug Regimen Review 
services in nursing homes, and 
with retail druggists to provide 
dispensing services. Each 
provider will be expected to 
invoice the HMO for services 
provided, though many HMOs 
are starting to ask their 
providers to control costs by 
agreeing to be reimbursed on a 
capitation basis, irrespective of 
the degree of use of the service. 

This may be attractive to 
those pharmacists providing 
services to a number of 
different HMOs, and for whom 
sending out monthly invoices 
for individual patients becomes 
rather complicated. 

One pharmacy director of an 
HMO in Connecticut told me 
recently that he saw the future 
of community pharmacists 
contracted with his HMO less in 
dispensing and more in 
education. His attitude was that 
the HMO is a purchaser of some 
very expensive health services 
and resources, all aimed at one 
outcome: getting the patient 

If we invest in medication as 
the means of treatment, and 
either the doctor chooses the 
wrong treatment, or the 
patient takes it incorrectly, the 

whole set-up collapses. These 
hugely expensive resources are 
wasted and we have to start 
again. This is not good for the 
patient, or the HMO. 

Far better, said the pharmacy 
director, to engage our 
pharmacists in working with 
doctors to improve the 
treatment — educating them 
about drug therapy and 
monitoring what they do. This, 
in essence, is what consultant 
pharmacy is all about. Equally, 
it is essential to educate 
patients about medication and 
to encourage compliance with 

"I would far rather pay a 
pharmacist to do this than to 
have them fill a prescription. It's 
much better use of their time," 
said the pharmacy director. 

Prior authorisation 

In the battle to contain rising 
drug costs, some HMOs and 
State Medicaid programmes 
have introduced an extra 
component to their formularies: 
prior authorisation. In this 
system, if a doctor wants to 
prescribe a drug for a patient 
outside of the formulary, 
permission must be obtained in 

For example, in the Arkansas 
Prior Authorisation Programme 
(1992), a patient may receive 
only two prescriptions for H2 
antagonists in any 12-month 
period. Further prescriptions 

require the doctor to fill in a 
prior authorisation request 
form which the pharmacist 
completes and sends off for 
authority to dispense. 

Pharmacists may receive a 
retainer from the HMO for 
providing this service, or they 
may provide it as part of the 
overall dispensing contract. 

Industry interest 

Pharmaceutical companies are 
taking a close interest in the 
benefits they might acquire 
from becoming directly 
involved in health 
management. The downward 
pressures on drug costs — 
especially from the HMOs — 
mean that their influence on 
prescribing is in decline. They 
are becoming involved in 
directly owning HMOs. 

The biggest HMO in the US, 
Medco, was acquired by Merck 
for a reported $6.6 billion. In a 
similar move, Smithkline 
Beecham bought Diversified 
Pharmaceutical Services for 
$2.3bn. Glaxo and Lilly were 
reported to have been in fierce 
competition to acquire another 
very large company, McKesson, 
with Lilly being the eventual 
winner. Both Glaxo and Sandoz 
are now reported to be 
interested in a company called 
Value Health. 

The advantages to the 
pharmaceutical companies are 
obvious. They no longer have to 
expend resources on trying to 
persuade prescribers to 
prescribe their products. They 
can impose a formulary which 
includes their products as first 
choice. Thus they regain control 
of their market. 

It is also true that by 
imposing well defined 
treatment protocols, based on a 
full assessment of the patient's 
clinical need, supported by 
extensive quality assurance 
activities, patient outcomes will 
be improved. The Government 
(or other institutional 
purchaser) keeps within budget 
and both the HMO and the 
pharmaceutical company 
remain in profit, which is to 
everybody's advantage as a 
proportion of the profit will be 
reinvested in improved services 
and the development of new 

HMOs in the UK? 

Certainly, one could think of 
FHSAs and health authorities or 
commissions as a type of HMO. 
But whether these will want to 
have such close relationships 
with the pharmaceutical 
industry remains to be seen. I 
cannot foresee such strong 
competition for NHS business 
that GPs would agree to accept, 
and pharmacists agree to 
monitor, prior authorisation 
protocols. However, I could see 
moves to pay pharmacists on a 
capitation basis, as this makes 
good sense from a purchasing 

I would certainly agree with 
the analysis of the HMO 
pharmacy director who said it 
makes sense to pay pharmacists 
to educate patients. Maybe this 
is one area of professional 
development which we could 
share directly with our 
colleagues across the pond. 


Chemist 8i 

Druggist 28 JANUARY 1995 

Quite simply you would be in the dark. 

No other medium delivers such a rich diet of 
information - technical data, industry news, analysis, 
insight and career opportunity. 

How else would you be able i«> keep in touch wiili 
change Inn through the pages ol \ our business 
magazine? Only your magazine gives you all the issues 
- large and small - supported by detailed analysis of 
the technical developments and structural changes 
occurring within your industry or profession. 

So von know precisely w hat the implications are for 
you and your business, both now and in the future. 

And what else, when you are buying goods and 
sendees, helps you remain reliably informed aboul your 
options? After all. the information you find in your industry 
magazine has been researched and written by experts. 

That's why the most active marketplace for goods 
and services lies between the covers ol business and 
professional publications. 

Its small wonder therefore, that the majority ol 
people at the top of their professions and business make 
reading their magazine a regular priority. 

Because only through a business magazine does an 
industry or profession keep seriously in touch with w hat 
really matters. 

So if you re looking for information, prepared and 
presented with your specific needs in mind, then reach 
for your magazine. 

h s the source ol information you can trust. 

To find out how business magazines can help 
you in your business, call Phil Cutts al PPA on 
(i~ I 379 6268. 


"ipi nbtMctl 1 1\ Argu> HiiMiir" Pul >l irn t ions • I I n* Builder Group • < lonstrut tion Publit ations • Emap Business < ommunu aii« .n- • FunlLiv Publn ati« .n- • 
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Dedicated to supporting die highest standards m business and professional pubhshing 

A pensioner, one of 
your regulars, leaves 
you his monthly 
prescription. Why, 
he demands, has the 
doctor given him a 

new heart drug 
when he didn't ask 
for one? He's not 
puffing any more 
than usual and his 
ankles aren't any 
worse. He's got 
enough ruddy pills 
to take as it ruddy 
well is, he complains 
as he walks out 

1. Why add an ACE inhibitor to 
an apparently acceptable 
treatment for heart failure? 

2. What are the correct initial 
and maintenance doses of 

3. How is treatment initiated in 
the community and why? Do 
you think this is likely to be the 
first prescription for enalapril — 
what action would you take 

4. Would you recommend a 
combined diuretic/ACE inhibitor 
formulation to help 

5. He's taking quite a dose of 
frusemide — do you think a 
potassium supplement is 

6. Can you see any other 
potential problems? 

pack and 



lull iotenam<? 

No o' '•••'<'■' "'•*"* : 




1. The combination of an ACE 
inhibitor and a diuretic has 
been shown to prolong survival 
and improve symptoms in 
patients with heart failure 
compared with a diuretic alone. 
Note that, although this 
gentleman has no complaints, 
he is still symptomatic. 

2. The initial dose should be 
2.5mg/day, slowly increasing to 

a usual maintenance dose of up 
to 20mg/day. However, GPs are 
reluctant to prescribe closes at 
the top of this range. 
3. Initiation of treatment with 
ACE inhibitors may cause 
profound hypotension, 
particularly in patients taking a 
high dose of diuretic; initiation 
in hospital is recommended if 
the diuretic dose is greater than 
80mg/day of frusemide. In 
patients with milder illness in 
the community, it is common to 
give the first dose at night, 
though medical supervision 
may still be necessary. It seems 
unlikely that anyone would 
attempt to begin treatment at 
10mg/day — it could, for 
example, be a follow-on script 

after initiation in hospital — 
but you should not dispense it 
until you have contacted the GP 
to clarify the issue. 

4. No. These formulations are 
indicated only if the patient is 
stabilised on the appropriate 
doses of the component drugs 
and compliance is a problem. 

5. No. Clinically significant 
diuretic-induced hypokalaemia 
is uncommon and there is a risk 
of hyperkalemia with ACE 

6. NSAIDs may exacerbate heart 
failure by promoting fluid 
retention and they increase the 
risk of renal damage with ACE 
inhibitors, though how import- 
ant this is with intermittent use, 
as in this case, is uncertain. 

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Chemist & Druggist 28 JANUARY 1995 

\l)\ I k I ISEMENT 

Study forges 
GP liaison 

An intervention study in dev- 
elopment at St Helen's and 
Knowsley FHSA aims to en- 
courage GP and pharmacist 

The study, a follow-up to a 
previous intervention analysis by 
the St Helen's and Knowsley 
area's pharmacy audit advisory 
group, will evaluate the com- 
munity pharmacist's input on 
serious drug interactions. "We 
wanted to analyse how many 
hospital admissions are saved by 
pharmacists," says audit facil- 
itator Judith Whittaker. 

Ms Whittaker hopes the study 
will not only evaluate the safety 
net that pharmacists provide, but 
will identify problem areas. 

News Extra 

PSNC's no to 

training link 

The linking of continuing 
education to NHS contracts has 
received a thumbs down from the 
Pharmaceutical Services Nego- 
tiating Committee. 

Responding to prosposals from 
the Steering Committee on 
Pharmacy Postgraduate Educ- 
ation (SCOPE) on a continuing 
education strategy for NHS 
pharmacists, the PSNC says it is 
"totally opposed" to linking 
training to contracts unless it can 
be satisfied that contractors' costs 
in respect of locums and time 
commitment can be met. How- 
ever, it is still supportive of the 
principle of continuing education. 

W Yorks looks for greater 
pharmacy input 

Community pharmacists in West 
Yorkshire should receive greater 
recognition and, possibly, more 
project funding, under the 
recommendations of a new joint 
health commissioning strategy 

The strategy for health service 
development in West Yorkshire 
will be published in April and will 
signify an increased role for 

POM to P switches 
need to support 

In response to Mr Jones' letter 
(C&D last week), may I please 
draw the following points to the 
attention of your readers. 

Efficacy of Anusol HC versus 
Anusol — my assessment was 
that there is little evidence that 
the hydrocortisone improves the 
base products significantly in 
the treatment of haemorrhoids. 
I still hold this view, despite the 
papers drawn to my attention by 
Mr Jones. 

To demonstrate that 
hydrocortisone improves the 
efficacy of the base formulation, 
good comparative randomised, 
blind trials are required. 
Unfortunately, none of the three 
trials cited delivers in this 

Reference 1 is essentially a 
description of a dermatologist's 
clinical experience in the use of 
Anusol with and without 
hydrocortisone. There was 
certainly no randomisation of 
treatment or blinding. 

Reference 2 details a series of 
case reports on the use of 
Anusol with hydrocortisone. 

Reference 3 describes a 

community pharmacists, says 
Geoff Newbery, director of 
primary care for the soon-to-be 
merged Calderdale and Kirklees 
Family Health Services Auth- 
orities and West Yorkshire Health 

"In the past, the FHSA has 
tended to concentrate on CPs but 
we now need to raise our sights 
beyond this," says Mr Newbery. 

double-blind trial of Anusol HC 
formulations with and without 
the local anaesthetic pramoxine. 
There was no comparison with 
Anusol on its own. 

Mr Jones states that the 
article did not seem to support 
the POM to P process. My brief 
was to inform readers about the 
value of the new P products over 
and above those currently 
available. If the evidence is not 
there, I am duty-bound to say 

As pharmacists, we need to 
convey information about the 
products we sell as objectively as 
possible. Occasionally, the 
outcome of an objective 
assessment may not be as 
palatable as I, or manufacturers, 
would have hoped. 
Unfortunately, there is little we 
can do about this except to 
attempt to develop even better 

Indeed, I fully concur with Mr 
Jones in his 'hope that 
pharmacists will see the 
continued switch process as an 
opportunity to forge closer links 
with their customers'. However, 
the position of pharmacists will 
be enhanced only if we can 
demonstrate objectivity in our 

miss out on 
health advice 

Healthy living advice fails In 
reach ethnic minorities, even 
though long-standing illness is 
more common in these groups. 

A new Health Education 
Authority survey of the health 
and lifestyle of ethnic minorities 
reveals health is disproportion- 
ately affected, compared to the 
white population: twice as many 
South Asian men die from heart 
disease before the age of 4(1; and 
Caribbeans have double the 
average risk of stroke. 

Education is critical, but the 
survey noted that 25 per cent of 
Indians and 4(1 per cent of 
Bangladeshis had not come 
across any form of health 
education. Those that had said 
television and CP leaflets were 
their most common source. 

However, improving education 
may be difficult as researchers 
discovered many people had 
problems understanding English. 

The HEA's 'Black and Minority 
Ethnic Groups Health and Life- 
style Survey' is available for £15 
from the Authority. 
• The Defeat Depression cam- 
paign has produced factsheets in 
five ethnic minority languages: 
Bengali, Chinese, Gujarati, Hindi 
and Punjabi. 

Many surveys have confirmed 
the high esteem pharmacists are 
held in. This has been 
hard-earned because of the 
profession's insistence to put 
patients first. Of course we do 
not succeed on every occasion, 
but at least we try. 

Increasingly, manufacturers 
will be required to objectively 
back up claims made for their 
products. The only way to do 
this is with well designed 
clinical trials of their products. 
Many companies are rising to 
the challenge and impressive 
data sets have been generated 
for some products by those 
companies, including Warner 
Wellcome. Unfortunately, with 
the older products this happy 
position is not always held. 

I hope Mr Jones will accept 
my assurance that I am in full 
support of the POM to P switch 
process, and thank him for 
giving me the opportunity to 
state this. The sad fact is that, 
occasionally, the data does not 
enable me to state this as 
forcefully as I would like. 

A Li Wan Po 

Professor of clinical pharmaceutics 
University of Nottingham 

Seasonal Hints 
and Tips from 
Reckitt & Colman 

Dear Lemsip 

/run a small pharmacy and 
do not have the capacity 
to stock the full quota of 
cold and flu products that 
exist on the market. Can you 
recommend the appropriate 
stock levels and degree of 
choice that I should offer the 
consumer in order to have an 
acceptable range? 

Chemist & Druggist 28 JANUARY 1 995 

Many of the major pharm- 
acy retailers calculate 
their choice of stock 
according to sales data. 
This will provide a list of main brands 
and respective cash rates of sale - a 
valuable tool for deciding which cold 
and flu brands to stock. Remember to 
bear in mind that you should also buy in 
products that you know sell well locally 
but which may not feature so well in 
terms of sales on a national level. Up to 
date sales data and other merchandis- 
ing tips are scheduled to be available 
from NPAmid 1995. 
National sales data will also be of 
great help to you when deciding 
whether to stock a brand that you do 
not already have. It will give you an 
idea of whether this brand is perform- 
ing and lessen the risk for you when 
you come to taking the decision. 
Planograms are also useful for estimat- 
ing how much space to allocate to indi- 
vidual product lines and consequently, 
how much stock to buy to fill the space. 
You should also be taking notice of 
products that are well advertised, 
such as Lemsip, as the loss of this sale 
could result in losing other potential 
sales in-store. 

This more methodical approach to 
stock levels will inevitably impact 
upon the choice of brands you are 
able to offer. The most important fac- 
tor according to Reckitt & Colman is 
that your pharmacy should aim to be 
as profitable as possible by maximis- 
ing sales per square foot. 
For further information, contact the 
Medical Information Unit. 

Reckitt & Colman Products ltd 


Putting It 
Together Better 
Than Ever 

A Growing Business 

Over the past 70 years, Weleda 
has continually enhanced its 
product range and customer 
service. Time-tested ingredients 
and traditional potentising 
methods today go hand in hand 
with stringent quality control and 
the most modern pharmaceutical 
technology. We are constantly 
improving and enlarging our 
manufacturing units to 
accommodate our growing 
business as the demand for 
natural medicines and bodycare 
products increases. 

National Advertising 

So that you can grow with us, we 
have committed our biggest ever 
spend to advertise our top Weleda 
Medicines in the health section of the 
Daily Mail and specialist women's 
health titles. Supplemented by 
additional brand-building advertising 
in health professional journals to 
gain recommendation, our campaign 
is designed to reach over 5 million 
new customers. And our anniversary 
public relations campaign will ensure 
the Weleda brand name is in the 
news throughout 1995, with a 
colourful support programme of 
advertorial promotions, exhibitions 
and Open Days, competitions and 
reader offers. 

New Products 

Product launches in 1995 will 
open up further opportunities for you 
to extend your Weleda range and 
offer a truly specialist selection of 
cruelty-free natural bodycare. 

New additions to our Iris Skin 
care range include a refreshing 
Toning Lotion and an all-over 
Moisturising Balm. Look out for 
Weleda's new Sun Tan Cream for 
Summer protection, plus a classic 
men's range in time for Christmas. 
And we'll be promoting our latest 
products with new sample sizes to 
encourage trial and help you to 
introduce your customers to the 
Weleda range. 

Support Literature 

A new full-colour Weleda Medicines 
booklet will soon support the range 
in-store. To encourage brand loyalty 
and a better understanding of the 
Weleda range, we'll be celebrating 
this Spring with a new publication, 
"Weleda News". We plan to produce 
two editions each year and, as with all 
Weleda literature, it will be freely 
available for you to give to valued 
customers. For our part, we will be 
sending out thousands of copies via 
direct mail to bring more customers 
into your store with news of our latest 

New Training Resources 

Over the years Weleda has shown 
a continued commitment to 
education and training and this year 
is no exception. In addition to our 
regular training programme, we are 
introducing a new seminar this year 
specifically designed for the 
pharmacy assistant. And our new 
collect-and-keep Training Manual 

will ensure your have the vital 
information you need to counter- 
prescribe the best Homoeopathic or 
Anthroposophic medicine for 
particular ailments. 

Building for the Futu re 

Hi Si 

Eyecatching point-of-sale 
material will give you a whole 
rainbow of fresh merchandising 
ideas for 1995. There are building 
bricks for stacking displays, 
birthday balloons, window decals, 
stickers, posters, showcards - we've 
put together a whole package to 
help you to healthier profits. Plus 
the chance to win some exciting 
prizes along the way with our 
nationwide window display 

Birthday Celebr ations 

In appreciation 
of your continued 
support over the 
past seven 
decades, we have 
planned an 
series of launch 
promotions, seasonal offers and 
unbeatable discounts throughout 
1995. So we'll all haye something to 
celebrate! / 


1995 marks a special anniversary for 
Weleda UK. We have specialised in the 
manufacture of Anthroposophic and 
omoeopathic medicines and natural 
bodycare products since 1925. Seventy 
years' experience means Weleda is the name 
you can depend on for your complementary 


Our range of Anthroposophic Medicines 
has grown over the past 70 years so we now 
offer yon a choice oi more than 100 ()l( 
remedies, pins an extensive range oi P and 
POM medicines, and medicinal herbs and 
leas. This year be si -selling Weleda 
Medicines will be backed bv a national 
advertising campaign to reach record 
numbers of new customers regularly 
rough the daily press 


Weleda Homoeopathies ha\e likewise 
developed since those early days, and 
Weleda now offer two OTC ranges, a 
comprehensive list of dispensed specials, a 
nil dispensing service and a pharmacy 
elpline. This year informative new 
literature will be available lor use in-store, 
and of course the vital training to help you 
ad\ ise your customers. 


I ast year saw the launch of Weleda Bod) 
Therapy, our cruelty-free bodycare range 
made with essential oils New product 
launches in l°°5 wilt mean more exciting 
profit opportunities for you this year. And 
we've put together a colourful support 
package of imaginative point-of-sale and 
window display material so you can join in 
our anniversary celebrations. 

puts it together better 

Weleda (L 'Ki Ltd, Heanor Road. 

Ilkeston, Derbyshire DE~ SDR 

Tel 01159 309319 Fax: 01 159 440349 

atural medicines - 
time for a re-think? 

In 1894, Matthews 
and Wilson Ltd — 
now Larkhall Natural 
Health — was 
founded in South 
LorocctetfiL The 
company made a 
vast range of herbal 
products as pills and 
liquids to BP and 
other requirements, 
providing a selection 
of remedies for the 
relief of common 
ailments. The 
present managing 
director, Dr Robert 
Woodward, looks 
back on a century of 
operating in the 
market of natural 
medicines, and gives 
his personal view of 
the industry's 
present status and 
of the way forward 
in the future 

It was not until the 1930s that 
product ranges changed. The 
influence of the medicinal 
chemists and the 1933 
Pharmacy Poisons Act were a 
watershed. The discovery of 
M&B 693 (Sulphanilamide) and 
penicillin began a revolution 
which, assisted by the birth of 
the National Health Service in 
1948, changed the scenario for 
medicine makers beyond 

The trend could be seen in 
the dramatic changes in The 
British Pharmacopoeia from 
1948 through to 1963. In the 
early 1950s, pills still retained a 
good deal of the Matthews and 
Wilson production, but tablets 
were gradually taking over as a 

At this time, pharmaceutical 
schools were changing 
emphasis. Botany and 
pharmacognosy were reduced, 
while organic chemistry and 
pharmacology expanded. The 
future was with the chemists 
and their powerful organic 
molecules with specific 
physiological effects. I was at 
college around this time and 
remember feeling increasingly 

Dr Robert Woodward points the way forward 

uneasy about the abandonment 
of our 'roots' and the blind 
faith in the power of the new 
molecules. It seemed clear to 
me that when the body was 
presented with a new chemical 
— while it might have 
beneficial short-term effects — 
in the long-term it could cause 
mayhem with body chemistry. 

In that climate, it seemed 
certain that tragedy just around 
the corner and, sure enough, it 
came in the 1960s with 
thalidomide and the birth 
defects it caused. Barbiturates 
were found to be addictive, 
antibiotics were losing their 

No 'Green' Act! 

The problems, none of which 
were related to herbal or 
homoeopathic medicines, led to 
public demand for more 
controls of products and 
manufacturers. The Medicines 
Act 1968 was born. I have been 
told the word 'medicine' in the 
Act was brought in at the 
request of the Royal 
Pharmaceutical Society, which 
did not want the term 'drug' 
used. In hindsight, it should 
have been a Drugs Act. In those 
circumstances, it probably 
would have left out: herbal and 
homoeopathic products. 

The herbalists thought that 
they should be included in this 
new Act, since their profession 
needed medicines. What they 
and the homoeopaths forgot 
was that any regulation in the 
medicines' area would be 
interpreted by people trained 
in the ways of modern 
medicine, simply because the 
medical and pharmacy schools 
were training people in 

disciplines relevant to those 
products. Producers of the 
modern medicines would have 
an influence commensurate 
with their market power. The 
herbalists and homoeopaths 
would be in the wilderness 
regulated by bodies which had 
no concept of their products or 
philosophies. It is that legacy 
which has led to the problems 
for herbalism in the 1990s. 

Safety of products must be 
paramount. However, 'safety' 
must be rationally defined and 
cannot be absolute. Even after 
the development of the 
licensing system, drugs passed 
as safe by the authorities have 
subsequently proved far from 
that. As a result, more and 
more controls have been 
brought in and, while these 
may be correct for new 
chemical entities, they have no 
relevance to herbs or 
homoeopathy. Particularly 
when one considers that no 
serious multiple incident has 
occurred with a herbal or 
homoeopathic product. 

Naturally safe? 

Natural does not mean safe, yet 
even the National Poisons Unit 
report on herbals — made so 
much of in the press recently — 
in no way demonstrates that 
herbal or nutritional products 
pose safety threats to the 
population. No one should 
decry the NPU's efforts in 
continuing vigilance, but what 
it proves so far is that there is 
no cause for major concern in 
the herbal area. 

How can people trained to 
understand purity of a single 
molecule produced by a known 
series of reaction stages begin 

to comprehend a naturally- 
made herbal ingredient which 
contains a whole spectrum of 
'active principles' in amounts 
that vary, depending on the 
climate, time of collection, 
plant subspecies, etc? If a 
product contains four or five 
such ingredients, the chemistry 
and pharmacy alone would 
defy every organic chemist in 
the world. It is impossible to 
ever be 100 per cent sure of a 
herb content. As for having to 
answer questions on 
pharmacokinetics posed by 
officials at the Medicines 
Control Agency examining 
herbal products, I'd like to 
know if they have got straight 
faces. If they have, then 
perhaps we should move in the 
men in the white suits now! 

An equitable regulation of 
herbs must be drawn up and 
enforced by people qualified in 
herbal medicine. The situation 
is unfair to manufacturers and 
consumers. Some herbal 
manufacturers deliberately 
exploited the licences of right 
granted to them in 1971 . They 
have converted these to full 
licences, because of political 
pressures, not because of 
technical excellence so far as 
chemistry, pharmacy and 
pharmacokinetics is concerned. 
These companies (all of which 
are smaller than any drug 
company of note) have 
enforced and abused a 
monopoly against consumer 

A similar situation exists for 
homoeopathy. These 
monopolies must be broken. 
They are stifling progress in 
natural medicine because, 
under the present system, no 


Chemist & Druggist 28 JANUARY 1995 

really new herbal medicines are 
being introduced. 

Consumer pressure 

Consumer pressure has ensured 
continued availability of herbals 
and homoeopathies, but these 
lay-consumers do not really 
understand that the industry is 
up against some of its own, as 
well as the pharmaceutical, 
monopolies. Recently, the MCA 
threatened to eliminate certain 
protections under the Act for 
practising herbalists. This 
problem has been temporarily 
overcome while experts define 
the term 'industrially produced' 
before new proposals are put 
forward. This is a waste of 
resources because what they 
should be debating is how to 
remove herbals and natural 
medicines from the straitjacket 
of the Medicines Act 1968. 

All herbal medicines and 
homoeopathies should now be 
decontrolled, except those 
containing a limited list of 
herbs and including those 
previously controlled under the 
Pharmacy and Poisons Act 1933. 
Natural medicine then returns 
to the status quo of 1 968. 

Modest claims 

Modest claims should be 
allowed for nutritional and 
herbal products without 
companies having to resort to 
Barbara Cartland-style plugs on 
the Jimmy Young show, or 
advertorial offers in the press, 
in a bid to circumvent the rules. 

I am sure that voluntary 
control through the Advertising 
Standards Authority and 

labelling through the trade 
bodies could work well — and 
at no cost to the Government. 
This would protect the public 
from abuses and open fair 

Consumers need protection 
from powerful synthetic drugs, 
but powerful financial interests 
have exploited safety of such 
products, in collusion with the 
Government, to provide 
expensive preparations which 
are not necessarily safe and 
that are costing tax payers too 
much. A total return to natural 
medicine is not what is wanted 
or desired, but people expect 
their masters to be sure that 
when they have something like 
migraine — a drug at £16 or so 
a dose is really worth that much 
more than a packet of 100 
herbal pills of Feverfew for £3. 

Equally, they need to be sure 
that modern drugs are not just 
distorting lifestyles. Perhaps if 
there were no powerful asthma 
drugs available, Government 
would be looking harder for 
the real cause of that problem. 
More importantly, are those 
drugs really helping the 
situation in the long-term? 

Finally to evening primrose 
oil, a natural oil which has been 
transformed by publicity and 
research to become a drug 
prescribed for eczema and 
breast pain at great cost to the 
NHS. All this oil really does is to 
correct a dietary imbalance 
which could be achieved by 
lifestyle changes without cost 
to the Government. If doctors 
wish to prescribe dietary 

Production techniques have changed, along with philosphies 

supplements for patients, good 
luck to them, but tax payers 
should not be asked to pay. 

Herbal medicine products, as 
well as homoeopathies, must be 
removed from the control of 
the Medicines Act. If the 
Government believes that 
controls are necessary, a new 

way must be found which is 
equitable to all. It is wrong to 
have enforced and passed a law 
(the Medicines Act) which can 
only be obeyed by a particular 
group of medicine 
manufacturers. Would it be 
right to make a transport law 
that only motor cars could pass? 


Goddard's Embrocation 

Topical analgesic used for muscular pain relief. 

Turnover in excess of £150,000 
U.K. only 

Please address enquiries la the address below and include relevant 
commercial and financial background information on yourselves 


Wright's Vaporiser 

Electrical vaporizer, inhalant block and 
vaporising fluid for night-time relief for 
coughs and colds. 

Turnover in excess of £500,000 
U.K. only 

Nightime Relief 

Coughs & Colds 

' Htl II I 

fan mi 

\P MIGHTS Hftp\ 

KIT - 

Shaun Davis f.c.m.a.. Finance Director 

LRC Products Ltd 

London International House 

Turnford Place 

Broxbourne. Herts. EN 10 6LN 

hemist & Druggist 28 JANUARY 1 995 



Glaxo's £8.9bn 
bid for top spot 

If Glaxo's £8.9 billion offer for 
Wellcome comes to fruition, the 
deal will create the world's largest 
drugs company, giving it econ- 
omies of scale to develop the next 
generation of drugs and further 
develop the two groups' pene- 
tration of the OTC market. 

The combined company will 
have a global market share of 5.3 
per cent, ranking it number one 
ahead of Merck and Co. 
According to Glaxo, the merged 
companies, to be called Glaxo 
Wellcome, will strengthen the 
marketing of Wellcome's drugs 
and improve its penetration in 
the US and other emerging 
markets, where Glaxo has a 
strong sales infrastructure. 

If Glaxo is successful in the 
takeover, Glaxo Wellcome will 
have a combined R&D spend of 
over £lbn, to help develop more 
drug technologies based upon 
cellular and molecular biology. 

A conditional offer was agreed 
between Glaxo and the Trustee of 
the Wellcome Trust late last 
Sunday evening. The offer for the 
Trust's 39.5 per cent share- 
holding is subject to the 
production of a High Court order, 
allowing the Trustee to enter into 
the irrevocable commitment to 
accept the offer. The final 
announcement of the deal takes 
place on January 27, after C&D 
went to press. 

If the Trust accepts the offer, it 
will be issued with 161 million 
new Glaxo shares, representing 
4.7 per cent of Glaxo's enlarged 
share capital. 

Sales up at 

Superdrug sales increased by 1.6 
per cent in the 23 weeks leading 
up to January, according to 
figures released by parent 
company Kingfisher. 

The company says the like- 
for-like sales performance has 
improved after a 2 per cent 
decline in the first half. 

Gross margins for Superdrug 
have been improved, according to 
Kingfisher, and it expects a good 
increase in profitability for the 
full year. 


Wellcome chief executive John 
Robb: in the light of Glaxo's 
unsolicited bid his company is 
evaluating all options 

Glaxo has valued each of 
Wellcome's shares at l,025p, 49 
per cent up on the January 20 
share price of 668p, the last 
dealing day before the an- 
nouncement of the final offer. 
This offer will be made on the 
basis of £722 in cash and 47 new 
Glaxo shares for every 100 
Wellcome shares. 

As C&D went to press, 
Wellcome pic had no comment 
on the takeover. It issued a 
statement through its advisors, 
Baring Brothers. The statement 
says: "Having regard to the 
unsolicited nature of the 
proposed bid, the Board is 
evaluating all available options 
for the company and its 
shareholders before reaching a 
conclusion on the course that it 
would recommend shareholders 
to pursue." 

Glaxo, with its war chest of 
£2bn, has been on the acquisition 
trail for some time. Glaxo deputy 
chairman and chief executive Sir 
Richard Sykes says the company 
has been pursuing possible deals 
for the past 12 months. 

Sir Richard says Wellcome was 
earmarked as a possible purchase 
because of its relatively small 
market share of 1.4 per cent. "Any 
company larger than this would 
have been difficult to integrate," 
he says. 

The strength of both com- 

panies in similar markets and the 
'synergy' in product lines with no 
particular overlap were also 
prime reasons for the purchase, 
says Sir Richard. 

The two companies have 
different portfolios of exisiting 
products, with Glaxo strong in 
asthma and respiratory drugs, 
while Wellcome depends on the 
sale of anti-virals. Both have 
strong research pedigrees, with 
complementary product lines for 
HIV/AIDS, hepatitis, cancer and 

There are obvious duplications 
in facilities and Sir Richard 
confirms that jobs are likely to go 
from research facilities, labs and 
sales and marketing, although 
the number of job losses, from a 
combined worldwide workforce 
of 62,000, have yet to be 
announced. City analysts est- 
imate that as many as 17,000 staff 
could lose their jobs. 

Sir Richard denies that the 
failure of Wellcome's Zorivax 
drug to gain immediate US OTC 
approval has any bearing on the 
decision. Both companies' best- 
selling drugs, Zovirax and Glaxo's 
Zantac — each making up 40 per 
cent of their respective com- 
panies' sales revenues — have 
patent expiry dates towards the 
end of the decade. 

Sir Richard says the combined 
companies' resources would 
allow increased drug develop- 
ment and faster time to market. 
He maintains the marketing 
ventures with Warner-Lambert 
will still go on, although there 
will have to be some changes. 

The acquisition is Glaxo's first 
since 1977 and represents a shift 
in corporate strategy in re- 
cognition of the changing nature 
of the pharmaceuticals market. 
The group has previously 
preferred to grow organically and 
has shunned the trend for buying 
distributors, with the Wellcome 
bid showing a preference for 
horizontal rather than vertical 

Glaxo has a new chairman in 
Sir Colin Corness, who took up 
the position last week, four 
months early. His appointment 
was announced last year after the 
resignation of Sir Paul Girolami 
as chairman and director. 

Pattni writ 
for Lloyds 

Praddip Pattni, whose company 
Ideal Health Group Ltd last year 
acquired his former businesses, 
Vital Health Ltd and Ideal Health 
pic, from the receiver, Ernst & 
Young, has now personally 
acquired Vital Health's £392,786 
claim against Lloyds Chemist 
Group subsidiaries, Farillon and 

Ernst & Young discountinued 
the court process begun with a 
writ for £396,786, issued against 
the Lloyds' subsidiaries on 
November 21 (C&D November 
26, 1994 and January 7, p25). 

A company spokesman for 
Lloyds says: "This is a claim 
without foundation which will be 
vigorously resisted. It is the same 
claim as made previously by Vital 
Health Ltd [in receivership], 
which was withdrawn." 


The European Agency for the 
Evaluation of Medical Products 
(EMEA) officially opens its doors 
for business this week at 7 
Westferry Circus, Canary Wharf, 
London E14 4HB. 

The new Committee for 
Proprietary Medicinal Products 
met for the first time last week. 
Professor Jean-Michael Alex- 
andre (France) has been elected 
as chairman and Dr Henning 
Hovgaard (Denmark) as vice 
chairman, both for a period of 
three years. The UK members of 
the CPMP are David Jefferys and 
Susan Wood. 

The full list of European 
experts upon which the EMEA 
will depend for vetting licence 
applications will be available to 
the Agency before the end of the 1 

costs soar 

The cost of crime and the number 
of incidents have risen, despite 
retailers spending a record £580 
million on security in 1993/94, 
according to a British Retail 
Consortium survey. 

Chemists were not among the 
big purchasers, spending on 
average £2,126 per £lm turnover 
on crime prevention, slightly 
below the average of £3,677. 

Chemist & Druggist 28 JANUARY 1995 

The Pharmaceutical Marketing Society's 1994 Craft Award for an OTC 
advertisement went to Zyma for a Eurax 'Itchy Feet' advert. Zyma's group 
brand manager, James Hall (left), receives the award from C&D's 
publishing director Felim O'Brien. C&D's publisher, Henn Publications, 
sponsored the award, presented at the Grosvenor House last Friday 

UK trails in 
Europe on 
drug spend 

Gatenby calls 
for focus on 
the future 

The role of pharmacists in 
influencing prescribing policies 
and monitoring drug usage is 
well established in hospitals and 
is showing signs of real growth in 
the community. 

But these are conventional 
roles, Mike Gatenby, general 
manager of Zeneca UK, told 
industry and advertising ex- 
ecutives at the annual Phar- 
maceutical Marketing Society 
Advertising Awards. 

"New roles are emerging that 
require more detail in definition 
and considerable work to be 
established," he continued. 

Strategically the pharmacy of 
the future will focus on 
patient-led services such as 
health promotion and OTC 
counselling. "Indeed, OTC will 
probably be replaced with more 

of lack of 

Shopworkers say they don't get 
enough training, according to a 
new report called 'Training 
Matters'. Nearly 2,000 employees 
were questioned by researchers at 
Leeds University, funded by the 
Distributive Industries Training 
Trust. The report discovered that 
shopworkers receive on average a 
total of 5.75 days' training with 
their current employer, getting 
about one day of training per year 
of service. 

Numark signs 780 

Just over 780 community 
pharmacists have signed with 
Numark in the run-up to the 
deadline of January 31. Man- 
aging director Terry Norris says 
he is confident that Numark will 
pass its target of 800 members 
by next Tuesday. 

Retail sales up 

Retail sales in December were 
0.5 per cent above the Nov- 
ember figure, and 3.8 per cent 
higher than December, 1993, 
according to seasonally-adj- 
usted estimates by the Central 
Statistical Office. 

New trading name 

Mawdsleys (Yorkshire) Ltd is 
the new trading name of Smith 
& Hill (Sheffield) — the local 
pharmaceuticals wholesaler 
bought by Mawdsley, Brooks 8i 
Co in February last year. 

Pfizer sales up 11pc 

Pfizer Inc sales rose by 11 per 
cent for the year to $8,281 
million with a net income of 
Sl,298m (S4.19 per share). 

appropriate consultation facil- 
ities on-site, and this is starting to 
happen," he said. 

Mr Gatenby forecast that 
pharmacy benefit managers, 
whose role in the US is to get the 
best value for money for the payer 
in terms of medicine supply, 

Comparisons exclude pre-tax 
charges taken in 1993. Total 
sales of pharmaceuticals rose by 
18 per cent for the fourth 
quarter and 13 per cent for the 

Roche results 

Sales in Roche's pharma sector 
rose 7 per cent to Sfr8.3 billion. 
The figures exclude sale from 
the Syntex Corporation. Sales 
for the Roche company as a 
whole rose by 3 per cent to 

E Merck share buy 

E Merck has acquired a further 
43.57 per cent of Lipha S A 
shares from Rhone-Poulenc. E 
Merck now owns 95 per cent of 
the capital of Lipha. Under the 
terms of the transaction, Lipha 
also acquires 25.11 per cent of 
the capital of Lipha's subsidiary 
Pharminter, held by Cooper. 

Zeneca staff rights 

Zeneca staff at various plants in 
the country have held a 
lunchtime demonstration to 
protest over the company's 
stance on trade union rights. 

would certainly be seen in some 
form in the UK, despite comment 
from the NHS Executive. 

The industry had responded to 
the changing NHS with regional 
business teams emerging, and 
regional marketing not too far 
away, he said. 

Wednesday, February 1 

Sheffield Branch, RPSGB, at The 

Jessop Hospital for Women, 7.30 for 
8pm. 'The chemistry of sudden death' 
by Dr A R W Forrest, clinical director 
of laboratory medicine, the Royal 
Hallamshire Hospital. 

Aberdeen and NE Scottish Branch, 
RPSGB, at the Postgraduate Centre, 
Aberdeen Royal Infirmary. 8pm. A 
review of alternative site care, 
including oxygen therapy and 
respiratory care. 

Edinburgh & Lothians Branch, 
RPSGB, at the Scottish Department 
of the Royal Pharmaceutical Society. 
36 York Place. Edinburgh. 7.45pm. 
'Medical hypnosis' by Dr Prem Misra. 
consultant psychiatrist, chairman of 
academic committee. British Society 
of Medical and Dental Hypnosis, 

Thursday. February 2 

Slough Branch. RPSGB. at the 

Training. Education and Dev- 
elopment Centre. King Edward VII 
Hospital. Windsor. 7.15 for 8pm 
(buffet). 'Brainwaves — epilepsy' by 
Dr Ley Sander. Chalfont Centre for 

The UK spends relatively little on 
drugs, lagging behind Germany, 
France and Italy in Europe, 
according to market research 
figures on global sales from 
January to October last year. 

Drug purchases from UK retail 
pharmacies totalled $4.5 billion, 
an increase of 8 per cent, but less 
than half of the expenditure of 
Germany or France, according to 
IMS International's study of the 
world's top ten drug buyers. 

Italy is the only country where 
drug sales fell in the first ten 
months of last year, compared to 
the previous year, dropping 6 per 
cent to $o.l bn. The survey 
showed growth in Europe's top 
seven countries of 3 per cent, 
with combined sales of £38.4bn. 

Despite pressure worldwide 
from governments to cut spend- 
ing, there was a rise of 5 per cent, 
compared with the same period 
in 1993, with sales in the top ten 
markets climbing to almost 

The US, where president 
Clinton's health reforms have 
been stalled, was the biggest 
spender with sales of $43bn, a rise 
of 8 per cent over 1993 figures. 

The biggest increase in sales by 
therapeutic area was central 
nervous system drugs, which 
recorded an 8 per cent rise to 
$12.7hn in the top ten markets. 
Cardiovascular drugs were the 
biggest worldwide sellers, re- 
cording an increase in Europe of 
23 per cent to $8.7bn. 

The top ten markets are: the 
US, Japan, Germany, France, 
Italy, the UK, Spain, Canada, the 
Netherlands and Belgium. 

Advance Information 

Barking, Havering, Redbridge and 
VValtham Forest Local Pharma- 
ceutical Committee is holding a New 
Year's contractors meeting on 
January 30. 7.3(1 for Npm (buffet) at 
Palms Hotel. Southend Road, Horn- 
church, Essex. Speakers are David 
Sharpe. PSNC chairman: Mary Allen, 
head of professional and information 
services, NPA: and Mary Tompkins, 
head of prescribing at North Thames 
Regional Health Authority. Details 
from Hemant Patel. telephone: 0181 
984 7917. 

European Proprietary Medicines 
Manufacturers' Association is hold- 
ing a members' meeting on January 
31 (buffet evening on January 30) at 
the International Britannia Hotel. 
Canary Wharf, London. The new 
European marketing authorisation 
system: an opportunity for self- 
medication?' Details from AESGP. tel: 
Brussels 32 2 735 51 30. 
The Association of LPC Secretaries is 
running a presentation skills seminar 
on February 9 in York and February 
14 in Manchester. The seminars are 
open to all ALPS members. Details 
from Jean Rothwell. telephone: 01204 

More LIG brands 
up for sale 

London Internationa] Group is 
continuing with its ration- 
alisation programme by putting 
up for sale two more of its 
non-core over the counter 
brands. It is looking to sell off 
Goddard's Embrocation (turn- 
over £150,000) and Wright's 
Vaporiser products (turnover 
£500,000) for an undisclosed sum 
to any interested buyer. 

Andrew Reynolds, group legal 
adviser for LlG, says: "We want to 
sell as soon as possible, but it will 
not be a fire sale. We will only sell 

for the appropriate price." 

Wright's soap brand and 
associated stock were sold off last 
year to Smith & Nephew for 
approximately £2.4 million. 
Buttercup, Galloway's and Liqui- 
fruta were sold to Unicliffe. LlG is 
still negotiating the sale of Eucryl 
toothpowder, which was put on 
the market last April. 

The sales are in line with LIG's 
strategy to dispose of selected 
non-core UK health and beauty 
brands, leaving it to concentrate 
on its condoms and gloves. 

Coming Events 

Zhemist & Druggist 28 JANUARY 1995 




H E A L Til C A l< £ 

r mill oditjs lvidxicigtjr 

Excellent Salary + Bonus + Executive Car + Benefits 

Centra Healthcare is a young, growing consumer healthcare 
company boasting a range of key OTC brands such as Pepcid 
AC, Imodium, Arret, Pollon-Eze and Tyrozets. 

Their commitment to ambitious expansion is based on a 
continued innovative NPD program from their world 
leading parent company and highly professional 
sales representation. 

They are now seeking a Field Sales Manager with 
responsibility for seven Territory Managers in the South 
of England. 

Based in the Central South and reporting to the National 
Sales Manager you will be expected to drive sales growth 
and attain significant targets through the continued 
development of pharmacy accounts within the wholesale 
and retail sectors. 

Managing and training an already successful team you will 
control all aspects of account development including trade 
promotional expenditure and overall sales strategy. 
You will also have responsibility for designated 

key accounts and for establishing successful working 
relationships with key personnel in your sector. 

For this type of man-management opportunity the demands 
are tough: 

• You will have an exemplary sales background with 
demonstrable achievements in account management. 

• Your success will have earned you rapid promotion and 
given you at least two years man-management experience 
within a sophisticated OTC healthcare or personal care 

• Personal qualities are equally important - your 
outstanding strengths will be high levels of enthusiasm, 
energy and commitment that make you a natural 
motivator who leads from the front. 

In return you will be part of a team that expects quality 
management and relishes the prospect of further significant 
growth in a competitive market. 

To express an interest please write to Peter Williams at 
Michael Page Marketing, Windsor Bridge House, 1 Brocas 
Street, Eton, Berkshire, SL4 6BW 

Please quote reference 218534. 

Re^iMereJ Numbei 0058 

Michael Page Market) 

Specialist Recruitment Consultants 
London Windsor Birmingham & Leeds 

Registered Number 0065 


Full-time Pharmacist required to join 
active team managing four privately 
owned pharmacies Varied work, includ- 
ing extensive residential homes and 
private hospital duties. Good salary, 
flexible hours 

Contact: C. M. Broadburn 0472 
691529 business; 0472 692292 home. 

/ Khurana 



We require an experienced pharmacist to 
manage our Withmgton branch with 
immediate effect. Newly qualifleds will be 
considered as training will be given. Salary 
circa £25k+. 

Please apply with CV to I. Khurana, 
MRPharmS, Khurana Chemist, 480 Witm- 
slow Road, Withington, Manchester M20 
3BG or telephone 0161 44 '5 3282 (day time). 


Part-time Pharmacist required 
for busy dispensing pharmacy. 
Approximately 20 hours per 
week by arrangement. 

Telephone: Geoff Taylor at 
College Pharmacy 0622 674020 
(day) or 0622 744250 (eves) 


We are helping ambitious professionally minded people create secure, 
long-term primary or secondary incomes. 


Call our info line and listen to a three minute recorded briefing 0374 
505100 (24 hours Std National BT rate). 

To register your interest phone Mr Y Nauthoa MRPS 0181 397 9001 or 

write to 72 Hunters Road, Chessington, Surrey KT9 1RT. 


Pharmacist Manager required 
for busy but easily run pharmacy. 
Minimum paperwork. Accommo- 
dation may be available. 

For further information tele- 
phone 0733 242580 or 340076 
after 7.30pm. 

NW LONDON. Offers invited from 
experienced (retail) pharmacists to 
work 1-2 days weekly, permanently in a 
busy pharmacy. Ring 0181 723 2834 
between 7.30-9pm evenings. 

LOCUMS WANTED. Regular or occa- 
sional days for a friendly independent 
pharmacy group, Southampton area. 
Please ring Mr T. Barlow (01703) 

PART TIME LOCUM required 2-3 
evenings per week on regular basis, 4- 
7pm, Walthamstow, London E17. Please 
ring 0181 520 1713 (9-7pm). 

(poss. part-time) required for busy 
pharmacy in Tunbridge Wells area. 
Phone 0892 529315 for details/inter- 

WALTHAMSTOW E17. Loaim/ Mana - 
ger required for 6 months from March 
to cover maternity leave. Tel: 0181 449 


EVENING LOCUMS required for in- 
store pharmacy. Mon-Thurs until 8pm, 
Friday until 9pm. Please contact Sarah 
Galley on 01702 555321 for derails. 

Chemist & Druggist 28 January 1995 












Add a healthy outlook to 
your local community 

(Would suit newly qualified) 

Continued growth has created career 
opportunities in our branches across the 
country, for pharmacists with the 
personality and drive to make a real 
impact on local community healthcare. 

Experienced or newly qualified (full 
training will be given), we need an 
individual with a commitment to 
patient counselling, coupled with the 
communication skills and management 
qualities to actively market a wide range 
of medicines, healthcare and leisure 

In return, you'll enjoy the full support of a 
highly professional company, modern 
well equipped and efficient facilities, 
flexible working hours and a highly 
competitive salary and benefits package. 
This will include; PPP membership, 
pension scheme with life assurance and 
generous staff discounts. 

Apply with CV to: Mr Roger Cotton 
MRPharmS, Recruitment and Training 
Executive, Moss Chemists, Fern Grove, 
Feltham, Middlesex TW14 9BD. 



NEW YEAR — new challenge. Ex- 
perienced Pharmacist required to man- 
age a pharmacy group shop with help of 
pre-registration student and staff sup- 
port. CV & references preferred Contact 
An|u (evenings). Tel: 0181 642 4200. 

CROYDON. Keen, enthusiastic Pharma- 
cist Manager Long term locum required 
to develop NHS and OTC of branch 
pharmacy now. Phone evenings 0181 

Grays, Essex. An enthusiastic pharma- 
cist required for a pleasant community 
pharmacy Experience in counter medi- 
cines necessary Ring 0181 690 6060 
days, 01708 438064 eves. 

SOUTH. Enthusiastic and industrious 
manager required for busy branch 
pharmacy in attractive market town. 
Excellent supporting staff and minimum 
paperwork. Tel: 0161 928 4260. 



Telephone Harrogate (0423) 531571 

Wharfedale Town 

High class pharmacy and perfumerv with 
prestigious Clarins Beauty Studio. Cen- 
trally located in highly sought after affluent 
small town close to the Yorkshire Dales 
Est T/O 31/1/95 £450,00(1, GP around 
31%. Tenure leasehold. Much scope for 
expansion. Offers around £100,000 lor 
GW/Fix plus SAV 



Leasehold city centre pharmacy Projected 
T/O 3 1/3/95 under management £570,000. 
NHS items average 3,358 per month. 
Lnormous scope tor expansion Reasonable 
over-heads and showing good profits. 
Possible sale of freehold with investment 
potential if required. Realistically priced at 
£250,000 for GW/Fix plus SAV 

Good selection of other pharmacies available, marn never advertised. Please phone for details. 


Business or full time employment available on a part ownership 
basis for only £25,000 (approx.) Full time or part time 
employment guaranteed via contract. Possibility of complete 
ownership. Very easy to manage. No paperwork. NHS 
prescriptions 1,200. Would suit first time buyer with ambition to 
expand or an investment venture. Easy access via motorway. M6, 
M69, M I etc. 

Tele phone Mr Gill 0203 336992/338865 

Pharmacy Sales Representative 

A vacancy has arisen for an experienced, enthusiastic sales 
professional to join our salesforce calling on Retail Chemists, 
selling and merchandising our range of OTC products in the 
following area:- 


We offer a competitive salary, incentive scheme, company car, life 
assurance and contributory pension scheme. 

If you are interested in this exciting position, please apply in writing 
with your CV to:- 

Mrs V A Pressley 
Pharmax Limited 
Bourne Road 

Kent DA5 1 NX 


Provincial Pharmacy 
Locum Services 

We have over 3,000 pharmacists 
registered! Plus experience of handling 
over 100,000 bookings NATIONWIDE! 


Place your locum problem in the 

hands of our experienced co-ordinators. 
We will inform you the moment cover 
is found. We leave you to get on i CARDIFF 
with doing what you do best, ' 022254 i. 1 ^ N ^ 
running your business. 


rounding counties. Experienced and 
reliable locum available for odd days and 
emergencies. Tel: 0161 442 6817 

LUTON. Locum required from March 
20th to April 15th. Tel: 0582 560395. 

Barnsley February onwards. Tel: 0226 


Reliable Locum required for 
community pharmacy from 
27th February to 24th 
March, 1995, excluding 

Please phone Mr G. Hirani 

0171 834 4721 

Chemist & Druggist 28 January 1995 




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No one has more experience. Don't buy without first seeing 
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For further details please call: 01772 323763 

PILLS - Patient Medication Records 
POSHH Checkout - EPOS 
Hadley Hutt Computing Ltd 

ieorge Bayliss Road, Droitwich, 
Worcs. WR9 9RD 
Telephone: 01905 795335 
Fax: 01905 795345 



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Offer subject to availability & pre-payment 


0732 377322 




ILL/FAX MAIDSTONE (01622) 754427 
MOBILE (0589) 367605 







Free entries in "Business 
Link" (maximum 30 
words) arc restricted to 
community pharmacist 
subscribers to Chemist A 
Druggist. No trade 
advertisements will be 
permitted. Acceptance is 
at the discretion of the 
Publishers and depends 
upon space being 

Send proposed wording 
to "Business Link" using 
the form printed 

Appointments, situations 
wanted, and businesses 
for sale will be 
incorporated as lineage 
advertisements under the 
appropriate Classified 

To: Business Link, CHEMIST & DRUGGIST, Bcnn House, Sovereign 
Way, Tonbridge, Kent TN9 1RW. 



First names 



Personal RPSGB Registration number 

Telephone number 

Proposed advertisement copy (maximum 30 words) 


Chemist & Druggist 28 January 1995 


DIRECT LINE IS 0732 377322 

The Power 
of the Multiples. 

• Nucare is a national organisation of 
independent pharmacists 

• Over 300 members and growing 

• Nucare members enjoy group terms from 
suppliers of ethicals, toiletries, 
cosmetics, sundries, D&P etc. 

• A large list of best buys available from 
central distribution 

• You too can share in this by joining Nucare 

the Privilege 

of Independence. 

Wish to become a member? NllC3XC plC 
Please contact us Today. 447 Kenton Road 


Middlesex HA3 OXY 

Tel: 0181-732 2772 
Fax: 0181-732 2774 


A FREE Service for Chemist & Druggist Subscribers 

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Units 16-17 Be 

Tp|. M 


RADE LESS 30% - 2x100 Celance 
lOOmcg (exp 6/95). Tel: 01825 762959. 

RADE LESS 33%+VAT - 6 Zovirax susp 
125ml (exp 9/97), 15x100 Creon caps 

1 (exp 8/96), 5x10 Colomycininj 1,000,000 
(exp 1/97). Tel: 01304 812242. 

1x30 Colodress plus S866, 2x20 Cohesive 
ostomy seals 839002, 6 Alomide eye 
drops (exp 4/95). Tel: 01223 352086. 

HADE LESS 30%+VAT - 3x35ml Diflu- 
can susp 50mcg per ml, 9 Bicillin inj 
2.16g, 2x70ml Zinnat susp 125mg. Tel: 
0171-405 1039. 

*ADE LESS 30% - Loxapac 50mg, Pro- 
pylthiouracil 50mg, Aerocrom inhalers, 
Atrovent forte inhalers, Valoid 50mg/ml 
injections, Sandimmun lOOmg, Sorbid 
SA, Anquil tabs, Pragmatar lOOg, Depo- 
nit 10. Tel: 01602 785744. 


100 Naprosyn 250mg, 16 Floxapen 
250mg, 14 Tritace 1.25mg, 28 Trandate 
lOOmg, 3 Ichthopaste. Tel: 01963 

TRADE LESS 30%+VAT - 500 Nozinan 
25mg (exp 3/98), 1 14 Mogadon 5mg (exp 
7/98), 197 Uderfen F (exp 3/95), 380 
Loniten 2.5 (exp 1/95). 40 Ludiomil 
25mg (exp 5/95), 62 Nuelin 125mg (exp 
7/95). Tel: 01702 78820. 

Intron A 3 mega units, 119 Aldomet 
500mg, 87 Rocaltrol 0.5mcg, 100 Deseril 
lmg, 82 Ludiomil 50mg, 180 Bezalip 
mono. Tel: 01 15 9787472. 

TRADE LESS 30%+VAT - 73 Motnn 
800mg (exp l/95_, 380 Navidrex K (exp 
5/%), 56 Primalan (exp 5/95), 61 Pro- 
Banthine 15mg (exp 5/95). 44 Trandate 
lOOmg (exp 6/95), 36 Zovirax 400mg (exp 
2/95). Tel: 01702 78820. 

TRADE LESS 25% - 14 Pergonal injection, 

100 Loron. Tel: 01352 752050. 

190 Cystrin 5mg, 1 Rhinocort nasal 
spray, 36 Dyspamet chew tab 200mg, 42 
Adizem SR 120mg, 200 dipyridamole 
lOOmg, (exps 3-7/95). Tel: 01594 542517. 

TRADE LESS 40%+VAT - Baratol 
25mgxl00 (exp 1/96), Myambutol 
400mgxl00 (exp 3/97), Provera 200mg 
1x30 (exp 3/95), Zofran 8mgx40 (exp 
12/96). Tel: 01332 345906. 

TRADE LESS 35% - Celance lOOOmc tabs 
(exp 97). Tel: 01342 844424. 

2x28 Sectral 400mg tabs, 2 Ventolin resp 
solution, Aldactone 50mg. 20 Monit SR 
40mg, 20 Suscard 2mg, 200 Sinemet 
275mg, 3001 Temazepam elixir. Tel: 
0181-767 6005. 


2x10 Uniparin Forte inj 10,000iu/0.4ml. 

Tel: 0181-767 6005. 
TRADE LESS 30%+VAT - 168 Androcur 

50mg, 56 Cytotec, 28 Esidrex 25mg, 180 

Inderal 80mg, 100 Minocin lOOmg (exp 

5/95), 28 Moduret 25 (exp 3/95), plus 

others. Tel: 01926 612858. 

Bonetos 400mg (exp 8/95). Tel: 0181-460 



5 NOMAD TROLLEYS -with 16 size carrier 
holders £500. Tel: 0151-928 5513. 

STAMP COLLECTION - Huge! 50 stock 
books, ranging from very expensive GB 
to world wide including covers, will split. 
Tel: 0181-961 3653. 


Pharmacists are responsible for the quality, safety and efficacy of 
medicines they supply. In purchasing from sources other than 
manufacturers or licensed wholesalers, they must satisfy themselves 
about product history, conditions of storage and so on. 

oemist & Druggist 28 January 1995 





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♦ Finance 

Subject to financial 
status. We can offer 
attractive H P. or leasing 
terms including short 
term interest free loans. 


TEL: 0626 - 834077 

Chemist & Druggist 28 January 1995 

supports fit to. the 
back of the 

Total locking of 
the column 

Internal separa- 
tors with adjusta- 
bility to the nea- 
rest millimeter 

Possibility for fur- 
thes internal di- 

Metal mesh wire 
to drawer bot- 

Laminated pla- 
stic to drawer 

Perspex glass to 
drawer bottom 

Attention to detail makes the difference 

j brepSBs | 




We work in a pharmacy every day, 


We understand the pressures and 

constraints of running a modern 

retail pharmacy, 


We strive for professionalism, service 

and trust, 



we are approved by the NPA. 

Just a few reasons why successful 

Pharmacists have chosen us to plan 

and refit their business environment. 



Edison Road, St Ives Industrial Estate. 
St. Ives, Huntingdon, Cambridgeshire PE17 4LF 
Telephone. St Ives (0480) 494262 
Fax: (0480) 495826 



1 for £6.00 — 20 for £1 0.00 — 50 for £22.50 
— 100 for £40.00 


CALL 0171 485 4677 NOW 


Old chemist shop fittings, drug runs, bow 

cabinets etc. 
Complete shop interiors purchased. We try 
hardest, travel furthest, pay more. 
Telephone 0327 349249 
Eves 341192 
Fax: 0327 349397 

fie buy Perfume Tesiers, 
Via Is. Bottles and Display ' 

Total Discretion Assured 

Tel: 0254 871618 
Fax: 0254 390 652 
0254 871716 


Overruns, Returns, Damages 
& Shortdate 

Food. Drinks, Healthfoods. 
Cosmetics. Haircase. Conlectionery. 
Batteries, Sunglasses. Films, Suntans. 
Counter Medicinals. Soaps. 
Household etc 
Tel 01562 882476 or 0860 825825 
Fax 01562 884414 
Yes, we pay cash — Yes we collect 

Coleman & Co, Nationwide Service 

Chemist & Druggist 28 January 1995 



AAH clocks in over 2,000 BNFs 

AAH Pharmaceuticals has col- 
lected more than 2,000 old copies 
of the British National Formulary 
for Commonwealth Pharmaid 
Week (January 9-14). 

AAH van drivers picked up 
thousands of copies from 
pharmacists around the country 
and dozens were also donated by 
the Department of Health at 

The Commonwealth Pharma- 
ceutical Association asked the 
company for its help in the 
operation after its successful 
contribution last year. 

The books will now be handed 
over to Book Aid International for 

Left: Jon Merrills, deputy chief 
pharmacist at the DoH, and Elaine 
Harden of the Royal 
Pharmaceutical Society load 
outdated copies of the BiVF into a 
Vantage van, courtesy of AAH 



Sheila Chantler has been made 
community pharmacy develop- 
ment facilitator by Croydon 
Health Commissioning Agency. 

The part-time post (a 12- 
month contract) involves the 
evaluation of training needs of 
community pharmacists and 
their staff, and facilitating audit 
projects. Croydon HCA is sub- 
sidising an MCA Part I course, 
starting on February 28. 

Ms Chantler has practised as an 
independent community phar- 
macist and was previously audit 
facilitator for Wirral FHSA. She is 
also a tutor for the Centre of 
Pharmacy Postgraduate Educ- 
ation for Wirral and Chester. 

Wrafton Laboratories has ap- 
pointed John Marenghi as sales 
and marketing manager. 

Yardley of London has made Sue 
Biimnie group marketing director. 

John Leslie has been reappointed 
chairman of the Orkney Health 

Gordon Hockey is the new 
secretary to the Royal Phar- 

maceutical Society's statutory 

North Thames Regional Health 
Authority has appointed new 
chief executives to head up its 
health agencies: David Johnson 
for North Essex; Graham Butland 
for South Essex; Victoria Hard- 
man for Camden & Islington; 
Chris Outram for Enfield & 
Haringey/New River; and Laura 
Noel for Redbridge & Waltham 

Boots Contract Manufacturing 
has taken on Ann Griffiths as 
head of marketing sales for UK 
retailing and Ross Crombie as 
head of sales to Boots The 

Fred Hooker has been appointed 
UK sales manager for the 
Kleenkut Group. 

Davina Health & Fitness has 
appointed Belinda Lancaster as 

its marketing manager. 

Sarah Gant has been made head 
of communications at Sanofi UK. 

Warwick Owen has been pro- 
moted to marketing director of 
Wilkinson Sword. 

Zenaca has appointed Michael 
Pragnell as CEO of agro- 
chemicals and seeds. 

distribution to pharmacists and 
other health professionals in 
developing countries who are 
short of reference books. 

More than 47,000 copies of the 
BNF and 250 copies of Martin- 
dale's Extra Pharmacopoeia have 
been collected as part of 
Pharmaid since 1987. A record 
14,000 BNFs were collected in 


A Chepstow pharmacy which was 
damaged during a drunken street 
riot went on to win first prize in 
a local shop window display 

Pharmacist Peter Merrick from 
P C Merrick, Chepstow, Gwent, 
spent around £250 on replacing 
his shop window after it was 
smashed by vandals during a 
drunken fight. Says Mr Merrick: 
"They didn't take anything, but 
there were a lot of witnesses from 
the pub next door." 

The rioters also smashed the 
windows of a Red Cross branch 
and a house along the same road. 
Although Mr Merrick believes the 
incident was a 'one-off, he has 
stepped up security for the shop 
and the local council is looking to 
introduce security cameras along 
the High Street. 

Assistants Ros Williams and 
Dawn Howells-Ross were un- 
deterred by the incident and 
spent the next weeks arranging 

Mayor John Huntley presents the 
trophy to Mrs Howells-Ross and 
Mrs Williams 

the shop window on the theme of 
a Christmas tea party for the 
annual local town council 

Their efforts paid off and 
Chepstow's mayor, councillor 
John Huntley, presented them 
with a trophy and a £50 cheque, 
which they will spend on a night 
out in a restaurant. 

Mr Merrick says: "They spent 
more time on preparation this 
year and I left them to it rather 
than becoming involved. It was 
nice to get somewhere." 

Seventeen Lincolnshire pharmacy assistants have completed the MCA "art 
I course, subsidised by Lincolnshire Local Pharmaceutical Committee and 
Lincolnshire Health. Part II has already started and the courses are 
anticipated to run again in April. Joanne West, course organiser, and 
Alistair Farquar, course tutor, are pictured with the Part I participants 

Mono film output by London Scanning. North London. Printed by St Ives (Gillingham) Ltd, Gillingham, Kent. Published by Benn Publications Ltd, Sovereign Way, Tonbridge, Kent TN91 1RW. 
Registered at the Post Office as a Newspaper 26/20/8s. Contents © Benn Publications Ltd 1995. All rights reserved. No part of the publication may be reproduced, stored in a retrieval system or 
transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of Benn Publications. Benn Publications Ltd may pass suitable 
reader addresses to other relevant suppliers. If you do not wish to receive sales information from other companies, please write to Derek Shaw at Benn Publications Ltd. 


Chemist & Druggist 28 JANUARY 1995 





It makes sense to recommend Tagamet 100 to your customers 

Why? . 

Because Tagamet 100 is 
specifically designed... 

.../or your customers' needs. 

Only Tagamet* 100 provides 
longer lasting relief from the pain of 
heartburn, excess acid and dyspepsia 
than an antacid, with the additional 
indication of prevention of nocturnal 

And Tagamet 100 tablets were 
scientifically designed to be easy for 
your customers to take with a simple, 
differentiated dosage regime (1 tablet 
prevents night-time heartburn; 

TAGAMET 100 cimetidine 

Product Information Presentation White elliptical film coated Tiltob tablet 
containing 100 mg cimetidine. Dosage and administration Adults (incl. the 
elderly), children 16 years and over: Relief of heartburn, dyspepsia, 
hyperacidity: Two tablets with water when symptoms appear. If symptoms 
persist for more than 1 hour after the first close, a second close may be taken, 
but no more than 4 tablets in any 4 hours and no more than 8 tablets in any 
24 hours. Prophylactic management oi nocturnal heartburn: One tablet with 
walei one hour before bed time;. In all cases, not to be taken (or more than two 
weeks. If symptoms persist for more than two weeks or recur regularly, a 
doctor should be consulted. Not to lie given to children under 16 year s of age. 
Use Short-term symptomatic relief of heartburn, dyspepsia, hyperacidity. 
Prophylactic management of nocturnal heartburn. Contra-indications 
Hypei sei isilivily to cimetidine or any of the exetpienls. Precautions Not 
recommended in patients: wilh impaired renal function, hepatic impairment; 
taking oral anticoagulants, phenytoin, theophylline, intravenous lignocaino; 
middle aged or older patients with new/changing dyspeptic symptoms, any 
patients wilh unintended weight loss and dyspeptic: symptoms, because ol delay in diagnosis ol gastric cancer; wilh compromised bone 
marrow; in pregnancy and lactation. Use only on a doctor's advice in patients: 

2 tablets relieve daytime symptoms). 
The tablets even have a patented, 
easy to swallow shape. 

...for your profits! 

With our extensive national 
TV advertising NOW ON AIR, 
heavyweight consumer press campaign 
and a national educational 
communication direct to known 
heartburn and dyspepsia sufferers, 
Tagamet 100 has been designed 
with your sales' needs in mind. 

Recommend Tagamet 100 - 
it passes the acid test and will keep 
your profits in the very best of health. 

wilh any other illness, using any medication, under medical supervision for 
other reasons, with a history of peptic ulcer who are now using NSAIDS 
especially the elderly. Adverse reactions Diarrhoea, dizziness, rash, tiredness. 
Gynaccomaslia, occasional liver damage, confusional states (usually in the 
elderly or very ill), all reversible. Rarely thrombocytopenia, leucopenia, 
agranulocytosis, all reversible. Very rarely, interstitial nephrilis, acute 
pancreatitis, headache, myalgia, arthralgia, fever, sinus bradycardia, 
tachycardia and heart block, all reversible, aplastic anaemia, pancytopenia and 
anaphylaxis. Reports of alopecia and very rarely reports of reversible 
impotence but no casual relationship has been established at usual prescribed 
therapeutic doses. Product licence number 0002/0230. Retail Price Tablet 
(12 s) C2.29, (24 s) C3.99. Legal category P. Date of preparation 19th August 
1 994. 'Tagamet' and 'Til tab' are 

trademarks. ^§[» SmithKline Beecham 

SmithKline Beecham Consumer J^Mb ^ , , 

Healthcare, SB House, Brentford. **** Consumer Healthcare 

Middlesex TW8 9BD. 

Telephone number:0181 560 5151 . ■Tagamet is a registered trademark of 

Cl~l SmithKline Beecham 

Consumer Healthcare 

'Tagamet is a registered trademark of 
Smith Kline b French Laboratories Limited 


Whenever you celebrate the New Year, The Jenks Group would like to 
celebrate their appointment to handle Entrotabs. 

• A major established GSL status anti-diarrhoeal medicine. 

• Allows customer self-selection. 

• Dual action for quick relief of diarrhoea and stomach upsets. 

• Suitable for adults and children over the age of six. 





ENTROTABS PRODUCT INFORMATION Presentation: Brownish round, flat, bevelled edge tablets containing Attapulgite BP 360mg, Dried Aluminium Hydroxide 
BP 100mg, and Pectin USP 50mg. Uses: As an ad|unctive treatment for the symptomatic relief of stomach upsets and diarrhoea Dosage and administration: 
Adults over 12 years: 4 tablets at onset, then 2 tablets every three or four hours. Children 6-12 years, 1 tablet every four hours. The tablets should be taken with 
plenty of fluid. Not suitable for children under 6 years, except on medical advice. Contraindications, warnings etc: Precautions: In addition to the use of Entrotabs 
it is important to replace body fluid lost as a result of diarrhoea. If symptoms persist for more than 24 hours consult your doctor. If symptoms of dehydration are 
present, adequate fluid and electrolyte replacement have to be instituted. Pharmaceutical precautions: None Package quantities: Original packs of 24 tablets. 
Legal category: GSL Product licence number: 10536/0018. Product licence holder: Monmouth Pharmaceuticals Limited, 3 & 4 Huxley Road, The Surrey 
Research Park, Guildford, Surrey, GU2 5RE Date of preparation: November 1994. "Trademark registered user: Monmouth Pharmaceuticals Ltd 



Resiston ONE not only treats and prevents 
summer's nasal hayfever, it works on stuffy 
winter noses too. And we're making sure your 
customers get the message in a £250,000 
national press campaign. 

Customers with a 'constant cold' may be 
suffering symptoms of allergy. They can rely on 
Resiston ONE's combination of sodium 


cromoglycate and low concentration of 
xylometazoline hydrochloride (0.025%) to treat 
and prevent the symptoms with little risk of 
rebound congestion and no drowsiness. 

Make sure you're stocked up for new winter 
sales. Call the Resiston ONE hotline on 0509 
634000 extn: 341 1 5 now; it's a new pharmacy- 
only sales opportunity that's not to be sniffed at. 


Double protection against nasal stuffiness 

PRODUCT INFORMATION: Presentation Resiston One is a 10ml pump bottle containing a solution of sodium cromoglycate BP 2% w/w and xylometazoline HCI BP 0.025% w/v Inactives: Benzalkonium chli 

disodium edetate BP. Uses: Prevention, relief and treatment of allergic rhinitis (seasonal and perennial) Dosage and Administration: Adults and children over 5 years; one spray in each nostril four times a day. 

Contraindications: Known hypersensitivity to constituents Precautions: Caution in pregnancy; slight risk of rebound nasal congestion with prolonged use. Side-Effects: Occasionally, 

nasal irritation during the first few days of use Retail Price: 1 0ml bottle £3.79 Legal Category: P PL Number: 0113/0097. Further information is available on request FISONS pic, Cl§0^ 

Pharmaceutical Division, Coleorton Hall, Coleorton, Coalville, Leics LE67 8CP. RESISTON and FISONS are registered trademarks of FISONS pic. ■ Pharmaceul 




January 21,1 994 

Editor: John Skelton, MRPharmS 
Supplement Co-ordinator: 

Maria Murray, MRPharmS 
Art Editor: Tony Lamb 
Advertisement Manager: 

Ian Gerrard 

Publisher: Ron Salmon, FRPharmS 


United Newspapers public 

Michael Maladie wants to give 
up smoking for the new year 
and has come to the pharmacy 
for help 

New Year is traditionally the time 
when we try to adopt a healthier 
lifestyle, Zita Thornton gives us some 
helpful hints to make it happen 


Essential oils have many uses 
but as Sarah Pureed explains 
they must be used carefully 


A history of 


Diabetes has been recognised as a 
medical condition since the Pharaohs 
ruled Ancient Egypt 

Pain pathways 

Pharmacist Trudy Thomas 
guides you through pain 
management in the pharmacy 


Health & safety 
at work 

The workplace should be a safe and 
healthy environment. Diane Bailey 
outlines the responsibilities of 
employers and how employees can 
make work a safer place 


Published by Benn Publications Lid, (member, United Newspapers Groupl, Sovereign Way, Tonbndge, Kent, TN9 I KW Teleph 


Volume 7 Number 52 

January 1995 

There is still no cure for the 
common cold. Marianne Mac 
Donald investigates why, and 
reports on the latest 
research ^£ 

1)7 fi «.4422 Tel 

Beauty editor Liz Jones seeks out the 
finer things in life that don't cost a 


■x 'ril U Benton < I Pen simile 07 12 161534 

Zovirax* Cold Sore Cream in this 
issue is launching a competition to win 
a day at a top London health club 

Suffering from New Year blues and the strain of 
returning to work? Has a recent bout of flu or a cold 
triggered off an uncomfortable and unsightly cold 
sore? Zovirax* Cold Sore Cream offers the ultimate 
remedy - the chance to win a whole day of luxurious 
pampering at a top London health club. Fancy a swim 
or a work-out, an aromatherapy massage, a herbal 
body wrap or a jacuzzi? Then turn to page 32 for 
further details, and to discover what treats we have 
in store for the lucky runners-up. 
*Trademark. Always read the label (contains aciclovir). 

VER THE COUNTER 21 January 1995 


Happy New Year to you 
all! As we all know, 
January is usually the 
time we try to make 
good resolutions and 
give up any bad habits. 
We might make an effort 
to do more exercise, give 
up smoking or to eat a 
healthier diet. Working 
in the pharmacy you are 
ideally placed to 
encourage and support 
people who may be 
considering some of the 
popular options. 

On a different note, by 
now you should have 
written protocols to 
follow when selling a 
medicine or when a 
customer asks for advice 
for a medical condition, 
f'm sure that for many of 
you it was only a matter 
of putting down in 
writing good practices 
you have been following 
in your own pharmacy 
before the word 
'protocol' was a gleam in 
the Society's eye. 

In case you've been 
wondering, the idea of 
using protocols was 
introduced by the Royal 
Pharmaceutical Society 
after a series of 
consumer investigations 
suggested that the 
advice given to 
customers when buying 
pharmacy medicines was 
not as good as it could 
be. As pharmacy 
medicines are the 
unigue selling point of 
pharmacies it was felt 
that a more formal 
system was needed for 
their sale. 

Finally, if you are one 
of the few who has not 
yet suffered a cold, count 
yourself lucky. If you 
have been less fortunate, 
like me, you're probably 
looking forward to the 
warmer weather we 
should have when OTC 
comes out again in April. 

Maria Murray 
Supplement Co-ordinator 


There is a widespread, but mistaken 
belief that heart disease is a male 
problem. In fact it is the biggest killer 
of women in the UK, accounting for 
one in four deaths — 76,000 women 
annually. A new report has revealed 
that women could be facing an 
epidemic of heart disease in the near 
future as a result of increased levels of 
smoking in women and an ageing 
population which has a higher 
proportion of women. The male myth 
regarding heart disease has also 
contributed to women receiving 
inferior treatment for the condition, 
Research has revealed that women are 
less likely than men to be referred by 
their GP for specialist examination for 
suspected heart disease, are referred 
for treatment later in their illness, are 
less likely to receive surgical 
treatment, such as a bypass, and not 
surprisingly, take longer to recover 
than men. In its report, the National 
Forum for Coronary Heart Disease 
Prevention recommends more 
research into heart disease in women, 
action to reduce smoking in women 
and girls, and a national education 
campaign to raise awareness of the 

• Coronary heart disease: 
are women special? is available, 
price £1 1 .50 (including p&p), from 
Women and Heart Disease, PO 
Box 7, London W3 6XJ. Chegues 
payable to BSS. 

• The British Heart Foundation has 
also produced a leaflet on heart 
disease and women. Copies can be 
obtained by sending a large, stamped, 
self-addressed envelope to: Women 
and heart disease leaflet. British 
Heart Foundation, 14 
Fitzhardinge St, London W1H 

You can discover a lot about a 
person by looking at their nails 
— and not just if they're a 
confirmed nail nibbler. 
According to Dr David Fenton, a 
consultant dermatologist at St 
Thomas' Hospital London, a 
brief inspection of the nails can 
reveal the history of past and 
present illness, such as skin 
problems, and kidney disease as 
well as arthritis and dietary 

Sudden serious illness such 
as a heart attack or pneumonia 
can totally stop growth which 
produces horizontal depression 
or ridges on the nail surface. 
Lines can appear in a matter of 
days depending on the severity 
of the illness. It is an old wive's 
tale that white spots on the nail 
mean the person is lacking in 
calcium, they usually are caused 
by bumps and bangs to the nail. 
Pale nails can indicate anaemia. 

The second National Gargle 
Week, sponsored by TCP, 
begins on January 30, 1995. 
During the week there will 
be the launch of new 
consumer research into 
gargling and promotions 
through newspapers, 
magazines and radio. 

Congratulations to Yvonne D'Silva, the winner of the Just for Men 
competition, recently featured in OTC. Yvonne, who works at the 
Broadwick Pharmacy in London is pictured here receiving her prize 
of a Sharp Viewcam Camcorder from Derek Joys of Combe 


'Managing migraine — putting the 
pieces together' is a booklet from 
Roche for migraine sufferers. It 
includes information on identifying 
trigger factors and warning signs of a 
migraine attack as well as advice on 1 
how to cope with attacks. It has been 
endorsed by the Migraine Trust and 
the British Migraine Association, 
Copies are available by writing to: 
Roche Consumer Health, PO Box 
8, Welwyn Garden City, 
Hertfordshire AL7 3AY. 



Wednesday, March 8 is No Smoking I 
Day when an estimated two million 
smokers will try to give up cigarettes I 
for good. The No Smoking Day 
campaign is calling on all pharmacy I 
staff to help raise awareness of the 
day and to offer advice and support to 
those who want to give up. This year 1 
the group selected for special 
emphasis is smokers aged 40-50; a 
time when a mid-life crisis may 
prompt concerns about health. 
Information leaflets will be distributed!, 
through pharmacies. Helplines will bel 
in operation with advice on giving up:! 
England (Quitline), 0171 487 3000; 
Scotland (Smokeline), Freephone: 
0800 848484; Northern Ireland, 
01232 663281; and Wales, 01222 

The latest results from the world's 
longest running study of smoking 
reveal that the hazards associated with 
long term smoking have been 
underestimated. According to the 
study update, published in the Britis, 
Medical Journal, half of all regular 
smokers will die as a result of their i 
disease. The study also linked 
smoking to 24 diseases ranging from: 
cancers of the lung and stomach to 
tuberculosis and heart disease. 

However, on a brighter note the 
study confirmed that it is never too 
late to give up smoking. Even smoker: 
who gave up at 65-74 years of age 
had lower death rates (after the age of 
75) than those OAPs who continue to 


A camera for all 

Long gone are the days when 
inexpensive meant crude when you were 
talking about cameras — you get far 
more for your money these days 

The World Health Organisation (WHO) 
says there is no minimum level below 
which alcohol is good for your health 
and is advocating 'The less you drink, 
the better'. 

Research, recently published in the 
British Medical Journal, 
concluded that moderate amounts of 
alcohol have a protective effect on the 
heart. However, WHO specialists argue 
that there are other ways of reducing 
the risk of cardiovascular disease: 
avoid smoking, take some exercise, 
eat less fats. WHO says people already 
taking these precautions are unlikely 
to reduce their risk still further with 
light drinking. 

It believes that the publicity given to 
the concept of moderate drinking for 
health reasons is not the result of 
'rigorous scientific research, but is 
'inspired by commercial purposes'. 

The report in the BMJ, involving 
over 12,000 doctors, found that those 
who had one or two drinks a day had 
a much lower risk of death than 
non-drinkers or heavy drinkers. 

So it's not time for last orders yet! 

[ oH advise on 
infant diets 

Children should not be given solid 
food until the age ot foui months 
advises a report from the Depar'ment 
of Health. Previously it was 
'recommended that weaning could 
begin at three months. 

Further recommendations are: 
• Children should not be given cows' 
milk as their main drink until they are 
at least one year old 
» Bottle-fed babies should continue 
drinking formula milks during their 
first year 

» Vitamin A and D supplements are 
inly needed for babies over the age of 
fix months who are being breast-fed 
f Fruit, vegetables, potatoes and 
hon-wheat cereals can be used during 
he first few months of weaning. Meat, 
'iggs and fish can be added when the 
iaby reaches six to nine months of 


January 1... 

From January 1 all oral and external 
liguid medicines dispensed from bulk 
must be dispensed in a reclosable 
child resistant container unless: 

• The patient is elderly or 
handicapped and will have difficulty 
opening a CRC 

• The liguid is a sticky suspension or 
syrup which is incompatible with the 
closure and likely to clog up Ihe 

• The customer or patient specifically 
asks that a CRC not be used. 

From January 1 part-time workers 
are entitled to the same compensation 
rights tor redundancy and unfair 
dismissal as full-timers. 

Part-timers who work between eight 
and 16 hours a week can now claim 
redundancy compensation after two 
years' continuous service instead of 

Sunburn and the possibility 
of developing skin cancer 
are two of the less 
well-known hazards of a 
skiing holiday. As part of its 
skin cancer awareness 
campaign, the Health 
Education Authority is 
promoting the RAW facts on 
how to avoid burning: 

• Reflectivity. Snow reflects 
sunlight back onto the body. 
Freshly fallen snow can 
increase the amount of UV 
reaching the body by a 
staggering 85 per cent 

• Altitude. UV rays are more 
intense at high altitudes 

• Wind burn. Speeding 
down the slopes in the fresh 
mountain air can give skiers 
I hi' I ci 1st 1 impression that it's 
too cool to burn. 

The HEA recommends 
wearing a ski hat, goggles 
with UVA and UVB filters, 
and applying high protection 
factor suncream or sunblock 
to the face, neck, ears and 
other areas of exposed skin. 

The breakthrough came 
when the first compact 
cameras came on the scene, 
cameras that had many ot 
the features of 'serious' 
cameras but without their 
complications and at prices 
which were themselves 

It's all good news for the 
pharmacies, traditionally the 
High Street photographic 
stockists, for compact 
cameras offer a terrific 
opportunity to carry a range 
of economically priced 
cameras to complement 
sales of films and possibly to 
extend those sales to include 
albums, frames and other 
photographic accessories. 

Compact cameras retail 
from around £15.00, and a 
good 35mm compact can be 
purchased for under £50.00, 
although you can spend 
several hundred pounds. 

Special features 

Many of them have a 
red-eye reduction faciiity to 
minimise the chances of 
spoiling portrait shots. 
Red-eye reduction uses a 
beam of light or pre-flash to 
dilate the pupils before the 
picture is taken, thus 
preventing the subject's eyes 
looking like something out 
of a science fiction movie. 

Today, many compact 
cameras also have a wide 
angle lens so that they can 
take panoramic 
photographs, while those 
usually costing £100 or more 
have a powered zoom lens 
for those long distances 
shots, as welT as self-timers 
so the photographer can get 

in the picture too. 

Some makes will have 
their own individual features 
— for instance, Fuji DL 
compacts have 'Drop-in 
Loading', one of the simplest 
film loading systems. 

And because the vast 
majority of compacts use 
35mm film the results are 
better than with other 
amateur films such as 1 10, 
whose sYnaller negatives can 
mean poorer quality 
photographs with a 'grainy' 
look to them. 

Easy to use 

But the best thing about 
these cameras is that, 
despite all their technical 
sophistication, they are so 
easy to operate. To all 
intents and purposes all the 
photographer has to do is 
frame the picture in the 
viewfinder and press the 

Compacts are often 
supplied in packs complete 
with any batteries they 
might need and a film so the 
buyer can start taking 
pictures immediately and 
without any extra cost, while 
a simple handbook will tell 
him all he needs to know to 
get the best from his camera. 

You don't have to be an 
expert to use a compact 
camera — and you don't 
have to be an expert to sell 
one. As far as the 
pharmacy's concerned, 
that's perhaps their most 
attractive feature. 

[Material for this series is 
supplied by Fuji Photo Film 
(UK) Ltd) 

ongratulations to pharmacy assistant Marie Ashcroft, the winner 
f a wordsearch competition organised by Adcock Ingram, the 
manufacturers of Bioplus Liquid. Marie, from Stourport on Severn is 
ictured receiving her tickets for a weekend in New York from 
dcock's business manager Jim Ritchie and territory manager 
uaia Hughes 

>VER THE COUNTER 21 January 1995 


The Maladies 

Arthur: "I see you've got a 
window display about 
smoking. I d like to stop 
smoking, but I've tried a few 
times already without much 

Assistant: "I'm pleased to 
hear that you've decided to 
give up as that's a big step. 
Is there any reason why you 
want to stop? 

"One of my friends at work 
who smokes quite heavily 
recently had a heart attack 
and the doctors blamed his 
smoking. So, I've made it my 
New Year's resolution, yet 
again, to give up. I just 
wonder if it's worth it at my 

"You might find this hard to 
believe but it's never too late 
to give up smoking. Studies 
have shown that even old 
age pensioners who give up 
live longer than those who 

"I have tried giving up a few 
times, but it's so difficult. " 
"I don't think anyone could 
argue that giving up 
smoking is easy! Nicotine is 
highly addictive, and 
smoking over a number of 
years becomes such a habit 
that if you're not smoking 
you don't know what to do 
with your hands. 

The good news is that the 
vast majority of ex-smokers 
had some unsuccessful 
attempts at giving up before 
they finally succeeded." 
"// that's the case, how can 


Cut it out 

Arthur Maladie has been a regular 
smoker for six years. Each year his New 
Year's resolution has been to give up but 

this year he's determined to succeed 

the nicotine patches or gum 
I see advertised help me?" 
"If you've been smoking for 
a number of years you are 
probably addicted to 
nicotine. Once you stop 
smoking you get withdrawal 
symptoms such as headache, 
dizziness, nausea and 
irritability. A dose of nicotine 
can relieve these symptoms. 
After a few weeks, once you 
have got out of the habit of 
smoking, the dose of 
nicotine is reduced and 
eventually stopped." 
"What's the difference 
between nicotine in a 
cigarette and a patch or 

"None, but a cigarette 
contains up to 4,000 other 
substances as well as 
nicotine. The tar, carbon 
monoxide and other 
carcinogens produced by the 
burning of tobacco are the 
toxic elements that increase 
the risk of cancer and heart 

"Which is better — nicotine 
gum or patches?" 
"They both work in different 
ways and are suitable for 
different types of smokers 
and situations. 

Patches release a 
controlled amount of 
nicotine into the system 
through out the day. 
Chewing nicotine gum 
releases the drug which is 
guickly absorbed in the 
mouth and can guickly 
relieve a craving. 

Nicotine lozenges are 
available in the pharmacy, 
although they tend to have 
lower concentrations of 
nicotine. A nicotine nasal 
spray is available but only 
on prescription from your 
family doctor. 

Other smoking cessation 
aids which act by reducing 
the craving are available 
over the counter but many 
smokers give up without 
using any special products 
just their will power." 

Smoking facts 

Although smoking is an 
expensive habit that causes 
heart disease, cancer and 
over 100,000 deaths 
annually, there are still 
around 12.5 million cigarette 
smokers in Britain. 

The cost to the NHS of 
treating smoking-related 
illness has been estimated as 
£610 million a year. As a 
result the government has 
targeted smoking cessation 
as a key area in The Health 
of the Nation. 

The optimistic targets are 
to reduce the prevalence of 
smoking in the population to 
20 per cent by the year 2000, 
and to reduce the 
prevalence among 11-15 
year olds by a third. 

Most people are aware 
that smoking causes heart 
disease, lung cancer and 
emphysema, but it has also 
been linked to an increased 
risk of many more diseases 
ranging from peptic ulcer to j 
cancers of the mouth, throat 
and pancreas. 

New research suggests 
that the dangers of 
long-term smoking are much 
greater than previously 
thought. It now seems as if 
half of all smokers will die as 
a result of their habit 

Smoking during 
pregnancy not only harms 
the mother but the child as I 

Continued on p8 ► 

OVER THE COUNTER 21 January 1.S 

Britain's most popular programme 
is back on the box. 


Patch Programme to help you stop smoking 

7 days supply of large size nicotine patches 
for smokers of 20 or more cigarettes a day 

otinell is the most popular nicotine patch 
'ram me in Britain. So popular in fact, that it has 
iminant 54% brand share' One of the reasons for 
{remarkable success is the consistent heavyweight 
irtising support we have put behind the brand. 


1995 is no exception. We will be investing a massive 
£3.1 million, starting over the key New Year period. 
Nicotinell has been brand leader ever since its launch 
in May 1992.' It helps smokers 24 hours a day. Now 
we'll be giving you round the clock support as well. 

tion: Transdermal Therapeutic system containing nicotine, available in ihree sues (30, 20 and lOcm-'l releasing 2 1 mg. I4mg and 7mg ol nicotine respectively over 24 houn Indication: Treatment ol nicotine dependence, as an aid to smoking cessation Dosage: Stop smoking completely when starting 
» those smokmg 20 or mote cigarettes a day, treatment should be started with NlCOTlNELl TTS 30 once daily Those smoking less should start with NICOTINELL TTS 20 once daily Sires ot 30. 20 and lOcrrv permit gradual withdrawal of nicotine replacement, using treatment periods ot 3-4 weeks with each 
)ove 30cm ; have not been evaluated The treatment is designed to be used continuously lor three months, but not beyond However, il still smoking at (he end ol the three month period, further treatment may be recommended following a re-evaluation ol the patients motivation Contraindications: 

occasional smokers, children under 16 years As with smoking. NICOTINELL is contraindicated during acute myocardial infarction, unstable or worsening angina pectoris, severe cardiac arrhythmias, recent cerebrovascular accident, pregnancy and breast feeding, skin diseases preventing patch application and 
iensitivity to nicotine Precautions: Hypertension, stable angina pectoris, cerebrovascular disease, occlusive peripheral arterial disease, heart failure, hyperthyroidism, diabetes melhtus, renal or hepatic impairment, peptic ulcer Persistent skin reaction to the patch Keep out of the reach of 
at all times. Side effects: Smoking cessation causes many withdrawal symptoms Most common adverse effects directly related to nicotine patches are reactions at the application sue (usually erythema or pruntus) Other events which may be related to smoking cessation include headache, sleep 

gastro-mtestinal disturbances, and myalgia Legal category: P Packs: NICOTINELL TTS 10 (PLOOOI/OI73) in packs of seven patches, trade price £8.21. retail price £14.47. NICOTINELL TTS 20 (PLOOOI/0174) in packs of seven patches, trade price £8.64, retail price £15.23. NICOTINELL 
01/OI7S) m packs of seven patches, trade price £9.07, retail price £15.99. ©denotes registered trademark PL Holders: Ciba Geigy Pic. Macclesfield SKI0 2NX further information is available from Zyma Healthcare, Holmwood RH5 4NU Date of preparation: December 1994 I294/6S5 


€omfmis®d from p& 

well. It has been linked to 
miscarriages, low birth 
weight and cot death. 

So there is little doubt that 
ex-smokers are better off — 
and not just financially! 

Giving up 

Giving up smoking can be 
extremely difficult. Nicotine 
is a highly addictive drug — 
some cocaine and heroin 
users rate it as more difficult 
to give up than their illegal 

This is not surprising when 
you consider that smokers 
get a 'hit' of their drug on 
average 25 times a day, and 
when they inhale from a 
cigarette they 'score' within 
ten seconds when nicotine 
hits those brain cells. 

Cutting down on the 
number of cigarettes or 
switching to a milder brand 
does not work. A smoker 
who is serious about 
stopping must pick a day 
and stop. 

Many smokers do this 
without any help, but for 
those who have tried and 
failed there are a number of 
products that can make it 
seem a bit easier. 

Most smokers have to try 
a few times before they 
finally kick the habit. It is 

worth telling the customer 
this so that they don't give 
up trying when they have a 
minor hiccup. 


Nicotine replacement 
therapy (NRT) can help 
smokers overcome the first 
few difficult weeks. It 
relieves the symptoms of 
nicotine withdrawal while 
the smoker is getting used to 
life without cigarettes. 

Combining NRT with 
support and advice is one of 
the most effective means of 
stopping smoking. A wide 
range of delivery systems is 
available to get nicotine into 
the bloodstream. 
• Patches 

There are three different 
patches on the market — 
Nicorette, Nicotinell and 
Niconil. The patch to choose 
depends on the individual 
smoking habit of the 

Nicorette patches are 
applied daily for 16 hours 
over a period of 12 weeks 
and come in three strengths 
(5mg, lOmg, 15mg). 

Nicotinell patches are 
designed to be worn 24 
hours a day for two to three 
months. There are three ; 
sizes — 10, 20 and 30cm", — 
which deliver 7mg, 14mg 
and 21mg of nicotine 
respectively over a 24 hour 

Niconil are 24-hour 
patches available in two 
strengths — llmg and 22mg. 

All three manufacturers 

• Gum 

Nicorette gum is available in 
2mg and 4mg strengths, and 
in mint and original flavours. 
It is important that customers 
are advised on the correct 
way to chew nicotine gum. 

It should be chewed 
slowly until the taste is 
strong then placed between 
the cheek and gum to allow 
the nicotine to be absorbed. 
Once the taste has gone it 
should be chewed again. 

• Nasal spray 
Nicorette nasal spray was 
launched earlier this year 
and is only available on 

Ten tips for stopping 

1. Pick a day 

Cutting back on the number of cigarettes you smoke or 
changing to a 'lighter' brand does not work. Pick a day to 
give up cigarettes completely. 

2. Remove all temptation 

Get rid of all cigarettes as well as ashtrays, matches and 

3. Stop with a friend 

It's easier if you are not the only person in a group giving 
up and you have someone to sympathise with. 

4. Avoid situations where you might smoke. 

I For the first few weeks avoid situations where you used to 
smoke or where you are likely to be offered cigarettes. 

5. Cash not ash 

Collect the money you save somewhere visible, eg a glass 
; jar, and put it towards a treat. Someone who smokes 25 
cigarettes a day could save over £1,000 a year. 

6. Alternative activities 

Keep yourself busy so you do not have time to dwell on 
your nicotine craving. Try chewing gum or taking 
exercise. Avoid eating snacks instead of smoking as you 
will put on weight. 

7. One day at a time 

' It is more daunting if you try and give up 'for ever'. Each 
morning decide you will not smoke on that day. 

8. If at first... 

; If at first you don't succeed, try again, and again. Most 
; ex-smokers had to try a few times before they were 

9. Ask your pharmacist 

Many pharmacies now run smoking cessation clinics and 
there are a range of products available over the counter to 
help overcome the nicotine craving. 

10. Visit your GP 

Your GP can help you develop a smoking cessation plan 
which may involve nicotine replacement therapy. The 
nasal spray form of nicotine (Nicorette Nasal Spray) is 
only available on prescription. 

recommend that the patches 
are used as part of a smoking 
cessation programme. To 
this end they supply support 
material and in some cases 
telephone helplines. 

Patches should be applied 
to a clean, dry, non-hairy 
area of skin on the body or 
the upper arm, and the site 
should be varied. 

It has been suggested that 
the 24-hour patches are 
more suitable for smokers 
who crave a cigarette as 
soon as they wake up in the 
morning. Some patch users 
have nightmares and if they 
are on a 24-hour patch they 
should consider switching to 
a 16-hour one. 

prescription. Nicotine from 
the spray is absorbed faster 
than from the patch or gum 
so it gives more rapid relief 
from craving. It is said to be 
useful for heavy smokers, 
o Lozenges 

Stoppers and Resolution are 
lozenges containing 0.35mg 
and 0.5mg nicotine 
respectively. The lozenges 
should be allowed to dissolve 
slowly and not sucked, 
chewed or swallowed. 

Taking care 

As with all medication there 
are certain groups of 
patients who should be 
referred to the pharmacist or 
to their GP before starting on 

NRT. Nicotine replacement 
is contra-indicated during 
pregnancy and for breast- 
feeding mothers. However, 
some doctors would argue 
that it is preferable for a 
pregnant woman to be on 
NRT than cigarettes. 

It should also be used with 
caution in patients with 
heart disease, peptic ulcers, 
diabetes and an overactive 
thyroid. Nicotine patches 
should not be used in 
patients with chronic skin 
conditions such as dermatitis 
and psoriasis, as they may 
cause irritation. 

Customers should also be 
advised not to smoke while 
on NRT. 

Other options 

NRT products have a high 
profile in the pharmacv«tat 

there are other products 
available to help the smoker. 
Nicobrevin A 28-day course 
of these capsule is said to 
reduce the cravings and 
withdrawal symptoms 
experience by the smoker. 
The capsules contain 
menthyl valerate, guinine, 
camphor and eucalyptus oil. 

■ : iii,f« ihiiuiiiry MyiMUiool. 
Window displays 
highlighting smoking 
cessation can encourage 
smokers into the pharmacy 
to seek advice and 
information. Many 
pharmacies now run 
smoking cessation clinics, in 
some cases charging for the 

Your pharmacist may be a 
member of the Pharmacists 
Action on Smoking group 
(PAS), set up by the National 
Pharmaceutical Association 
with support from Pharmacia. 

ft has been proven that 
smokers who are offered 
advice and support from a 
heatth professional while 
they are trying to give up 
their habit are much more 
successful than those who 
don't. This applies to 
smokers who are also using 
nicotine replacement 
therapy or other smoking 
cessation aids. 

A recent survey of 
smokers found that nearly 
three-guarters wanted to 
give up, so let's do all we 
can to help them! 





(Contains Nicotine) 

more than just a patch 

ATEDPRESC RIB1NG INFORMATION: NICONIL PRESENTATION: A transdermal nicotine patch, available in two strengths (Niconil 22mg per day and Niconil Ilmg per day). INDICATION: Relief of nicotine withdrawal symptoms. DOSAGE: 
iuld stop smoking before commencing treatment. Normal course of therapy is six weeks (four weeks Niconil 22mg plus two weeks on Niconil Hmg or Niconil 22mg).PREC AUTIONS: Histon of angina, recent myocardial infarction or cerebrovascular accident, 
liac arrythmias, systemic hypertension or peripheral vascular disease, history of peptic ulcer, diabetes mellitus, hyperthyroidism, phaechromocytoma, chronic generalised dermatological disorders. Nicotine ma> induce dependence, to minimise ni. do not use bevond 
ONTRAINDll AT IONS: Children, non-smokers, occasional Miioker-. All forms of nicotine .ire contraindicated during pregnancy and breast feeding, and in acute myocardial infarction, unstable or worsening angina pectoris, severe cardiac arrythmias, transient 
laemic attacks and hypersensitivity to nicotine. SIDE EFFECTS: Application site reactions (eg. erythema and itching), headache, dizziness, nausea, palpitations, sleep disturbances. See full prescribing^^ 

*Jiconil22mg/dayand behavioural support materials £7.97RSP(cxcl.VAT).Niconil22rng d.»\ sevenda^ pack E7.40RSP(excl. VAT). Niconil llmg d.i\ sevenda\ pack i7.40RSP(exd. VAT). Legal category: P. Product licence nos. 10038 0017 0016.Froduct 
|er: Elan Pharma Ltd, Monksland,Athlone, Ireland. Date of preparation: Dec '94. Full prescribing infoiroarion available from tlanPhanna Ltd, Umben Court, Che Tel: 0I70i 02**43. 'Tradt mark i\\L>. 

It's easy to make 
a new year's 
resolution but 
even easier to 
break one. 
Whether it's 
losing weight, 
getting lit or 
breaking bad 
habits, the 
following advice 
from Zita 
Thornton could 
help your 
customers to turn 
over a new leaf 

Over-indulgence at 
Christmas can mean 
squeezing into your clothes 
in the new year, but 
however you choose to lose 
weight you'll get nowhere 
without commitment and a 
positive attitude. Whatever 
method you choose, it must 
be convenient and you need 
to make sure that you are 
still getting the essential 
vitamins and minerals to 
keep you in good health. 
Many people lind it 

A Happy and Healthy 

New Year 

Put the Christmas sweetie 
hinge behind you 

helpful to join a slimming 
club. Sessions start with a 
talk about choosing the right 
food groups and combining 
a diet with a generally 
healthy lifestyle. They 
provide the motivation and 
moral support to achieve 
your goal weight. 

This approach extends 
into slimming magazines 
available to everyone from 
newsagents, which have 
inspirational personal stories 
as well as tips on 

maintaining good health and 
developing a positive image. 

Calorie counted, ready- 
made meals are useful for 
busy working women. 

The World Health 
Organisation has advice for 
sensible eating that avoids 
putting on extra pounds: 

• Eat as much high fibre 
fruit and vegetables as you 

• Include bread, potatoes, 
pasta or other cereal foods 
with every meat. These high 
energy foods are rich in 
vitamins and fibre and 
should account for at least 
half of your daily intake of 

• Eat dairy products 
sparingly as they are high in 

• Substitute feaner chicken 
or fish as your main source 
of protein. 

• Reduce your intake of 
sugar and watch out for 
'hidden' sugar in biscuits 
and soft drinks. 

• Read labels carefufly to 
assess how low 'low fat' 
products are. 

Cut down on fat 

You can still enjoy your 
favourite recipes if you use 
the following lower fat 

• Use low fat yoghurt 

instead of cream 

• Make your own fruit 
yoghurts by adding fresh 
fruit to natural yoghurt. 

• Use low fat spreads on 
bread and for cooking. 

• Substitute medium fat 
cheese such as Edam or Brie 
in place of full fat hard 
cheese and use low fat 'light' 
soft cheese in desserts. 

• Remove the skin from 
chicken, and trim fat from 

• Brown meat and drain off 
excess fat before continuing 
to cook. 

• Scramble or poach eggs to 
avoid using fat for frying. 

Shape up 

If you are suffering from 
post-Christmas sluggishness, 
exercise can change all that. 
The more you use your body, 
the more you get out of it. It 
will help you to burn up 
calories too, but the benefits 
are even more far reaching. 

Taking regular exercise 
will firm up flabby muscles 
and increase suppleness. It 
will give you more strength 
and rather than making you 

tired, it wiil increase your 

Your heart is a muscie too 
and aerobic exercise — that 
is of a type which makes yoi 
take in more air — will help 
your heart to work better. 
Regular energetic activity 
improves the balance of fatt' 
substances in the blood 
stream and lowers the 
resting blood pressure givim 

OVER THE COUNTER 21 January 1< 

rotection against strokes. 
To get the maximum 
benefit from your chosen 
activities you need to do 
them three or four times a 
week for at least 20 minutes. 

Choose your sport 

The word 'sport' may remind 
you of cold and wet playing 
fields but competitive games 
are not the only way to 
exercise. It is important to 
boose something that you 
enjoy and that fits in with 
your routine. Go tor variety. 

Swimming is a good all 
round activity that tones 
muscles without strain. 
W Walking, jogging or 
pycling are accessible to 
rnost people. 
Using an exercise machine 
r exercise video means that 
ou don't even have to leave 
your home. 

If you are the sociable 
ype, then join a group for 
lerobics, step-up, karate or 
lancing. Energetic Latin 
\merican Salsa is the latest 
opular form of dance. 
Booking a regular court for 
adminton, tennis or squash, 
r joining a team for football 
k cricket could provide the 
potivation you need. 

exercise caution 

xercise is good for you 
rovided you observe the 
pllowing precautions: 
Don't attempt vigorous 
xercise to start with but 
uild up your fitness level 

Exercise can help you get 
ack into form after an 
peration but check with the 
octor about when and how 
mch to take. 

>VER THE COUNTER 21 January 

• Don't exercise if you feel 

• Stop if you are in pain or 
becoming exhausted. 

• Avoid injury by warming 
up your muscles with gentle 
stretching first. 

Stop smoking 

If you are looking for a 
resolution that will not only 
make you healthier and 
wealthier, but more popular 
too, then give up smoking. 

Experience the real taste 
of food and notice how 
people no longer turn away 
from the smell of stale 
cigarette smoke around you. 

Smokers between the age 
of 45 and 64 are three times 
more likely to die 
prematurely than 
non-smokers, and more 
likely to suffer from 
respiratory diseases, peptic 
ulcers, heart problems, 
strokes and cancer of the 
mouth and throat. 

Consider also that by your 
actions you are forcing 
others around you to smoke 

• It you have children, and 
you and your partner smoke, 
you could be making them 
inhale the equivalent of 150 

Reducincj your 
alcohol intake 

Mosl people drink more at Christmas than usual but 
when the celebrations are over it is wise to keep a check 
on your alcoholic intake. 
The recommended limits ol alcohol arc: 

• Women: No more than 14 units a week 

• Men: No more than 21 units a week 

A unit is equivalent to: a hall pint ol beer, a single 
measure of spirits or 
a glass of wine or 

Remember that a 
bottle of stronq, 
export lager accounts 
for two units. 

A habit of drinking 
over these limits will 
affect your health. 
Physical illnesses 
may include stomach 
disorders, depression 
and emotional 
problems, high blood 
pressure, vitamin 
deficiencies and 
eventually alcohol 

Even three units of 
alcohol will reduce a 
person's efficiency. 

It isn't difficult to 
slide into alcohol 
dependency and a 
danger signal is 

when you can take more drink without becoming drunk. 

There are over 40,000 alcohol-related deaths each year. 
When you are drunk you might think that you are the life 
and soul of the party, but who do you see laughing? It 
won't be you when you suffer a hangover the next day. 

It is far better to drink moderately within the 
recommended limits. This way of drinking can even 
reduce your susceptibility to heart attack and stroke, 
especially if you are a middle-aged man. 

If you feel that your drinking is getting out of hand you 
can speak to someone at Alcohol Concern about reducing 
your intake, or they will send information leaflets. Contact 

cigarettes a year. 

• As your cigarette smoke 
contains higher levels of 
many harmful chemicals, 
others will be inhaling 70 
per cent more tar than you 
will yourself. 

• There is an 830 times 
higher level of the 
cancer-causing compound 
N-nitrosodimethylamine in 
your sidestream smoke. 

• Expectant mothers who 
smoke increase their risk of 
miscarriage twofold. 

• Those who smoke 20 
cigarettes a day increase the 
risk of their baby dying at 
birth or soon after by 20 per 

Getting help 

There is plenty of help 
available for those who want 
to give up smoking. Nicotine 
replacement therapy, in the 
form of patches, gum or 
nasal spray, is readily 
available from your 
pharmacy or family doctors, 

and it does work! Some 
people find hypnotherapy 

Ben Wicks' book 'Stop 
smoking' (Sheldon £2.99) is 
easy to read and full of 
cartoons. Pick this up instead 
of a cigarette. In it, he 
compares a smoker to a 
junkie. They are both 
outcasts from society. 

Quitting the habit may 
well be the hardest 
resolution you have ever 
tried to keep but il you can 
stop, even after many years 
of smoking, you will still 
considerably reduce the 
dangers to your health. 

A fresh start 

The new year is a good time 
for making a fresh start — 
getting rid of bad habits and 
trying to develop some good 
ones. Set realistic targets for 
yourself, and remember that 
if at first you don't succeed, 
you don't have to wait until 
next new year to try again. 

1 1 

A full range of products 
the recognised brand lei 

pure essential oils 
massage base oils 
blended massage oils 
massage lotions 
natural antiseptic cream 
after wax oil 
hand & nail cream 
bath oils and soaksj 
shower gelss 
vegetable soaps! 
shampoos) : 
cream gel conditioners! 
electric vaporisersl 
fragrance burners! 

gift sets! 
wall charts| 

ongoing product development 
national advertising 
extensive point of sale material 
national sales team 
full customer support 

For further information 
phone 0273 325666 


and pa 

In recent years the 
popularity of aromatherapy 
has been phenomenal. No 
longer seen as cranky or tor 
hippies, the art of using 
essential oils for healing and 
wellbeing appeals to a wide 
range of peopfe in the 
spiritual nineties. 

For proof that 
aromatherapy has truly 
moved into the mainstream 
you only need look on the 
shelves of your local 
supermarkets — even they 
are putting oils in their bath 
and shower products. 

It's proving a huge 
money-spinner — in the UK 
we spent over £20 million on 
aromatherapy products last 
year. But if aromatherapy 
has filtered into all walks of 
life, many consumers are still 
unsure how to use the oils 
properly and safely, which is 
where you come in. 

Pharmacies are the main 
outlet for sales of essential 

Is, outstripping health food 
stores, and account for 80 
per cent of the market. So if 
your pharmacy doesn't 

ready stock aromatherapy 
ranges, then you should 
seriously consider it. 

Through the ages 

The art of using essential oils 
or therapeutic benefit goes 
ack about 6,000 years to 
the ancient Egyptians, who 
believed in anointing the 
ead as well as the living, 
nd to India, where the 
adition of using plant 
xtracts has continued to this 

The word aromatherapy 
was not used in Britain until 
he 1950s, when it was 
ntroduced via beauty 
parlours, not the medical 
profession, which is why for 
o many years aromatherapy 
r as considered just to be a 
nassage using essentiai oils, 
is only recently, with the 
evived interest in natural 
emedies, that aromatherapy 
|ias been taken more 
eriously in this country. 

What is 


[Aromatherapy is a holistic 
herapy, using fragrant 
ssential oils to treat both 
lind and body. The oils 
enetrate the system 
irough sense of smell and 
bsorption through the skin. 
Inhalation is the guickest 
'ay for essential oils to enter 
re body, and this can be 

I© \ & [is: 

The art of 

achieved by adding a few 
drops of oil to a warm bath, 
inhaling on a tissue, or using 
an oil burner or a vaporiser. 
• Essential oil molecules are 
tiny and so can penetrate the 
skin easily. Once they reach 
the dermis, essential oils 
pass through the tiny blood 
capillaries and are 
transported around the 
body's circulatory system. 
This is best achieved 
through massage, though 
adding oil to a bath will also 

work well. 

Most essential oils are 
antiseptic, while many will 
fight fungal infections such 
as athlete's foot, and others 
can combat viruses such as a 
cold, treat a headache or 
prevent sickness. 

An aromatherapy massage 
is also the ultimate 
anti-stress treatment after a 
long, hard day. The key to 
treatment is simply choosing 
the right oil and using it 

>VER THE COUNTER 21 January 1995 

Essential facts 

An essential oil is the extract 
ol (i single planl, lonnd in 
the tiny oil glands t hat 
surround the flower head. 
Some 300 of these natural 
extracts are used in 
aromatherapy today. The oil 
is neither greasy nor fatty, 
but a highly complex 
chemical compound which is 
volatile and highly 
flammable too. 

The oils are extracted from 
differenl parts ol the plant - 
tea tree oil is taken from the 
leaves and twigs, geranium 
from the whole plant, and 
jasmine from the flowers. It 
takes huge amounts of plant 
extract to produce just a 
small amount of essential oil 
- (10,000 rose petals make 
only an ounce ol rose oil, 
which is why it's so 
expensive. Lavender is much 
cheaper, since it is found in 
larger quantities in the plant. 

With essential oil, you get 
what you pay for. 
Recommend only pure 
essential oils for best results, 
not those which have been 
diluted. Because they are so 
concentrated you only need 
use a few drops. 

You can spot the 
difference between a good 
quality and a poor quality oil 
by trying this test: put the 
bottle of oil on a table in 
front of you and remove the 
lid. If the aroma wafts out 
then it is good quality; if you 
have to move closer to sniff 
it, then it's not. 

Recommended brands 

• Tisserand 

• Shirley Price 

• Nelson & Russell 

• Neal's Yard 

• Green Things 

Carrier oils 

Except for emergency first 
aid treatment, such as a 
sting or cut and then only 
with an indicated oil such as 
tea tree, essential oils should 
not be used neat on the skin, 
but always be mixed first 
with another substance 
called a 'carrier' such as 
vegetable oil or lotion. 
Good carrier oils include: 

• wheatgerm 

• almond 

• apncot kernel 

• jojoba. 

Each has its own beneficial 
properties, so bear that in 
mind when advising. A 
non-greasy vegetable-based 

Continued on pi 4 


Continued from pi 3 

lotion works well, 
particularly if using essential 
oils on yourself, as it is much 
easier to rub in. 

How much to use 


6-8 drops of essential oil on a 
tissue or in a basin of warm 
water (not for asthmatics) 

6-8 drops in a warm bath; 
soak for ten minutes 
Foot bath: 

4-5 drops in a basin of warm 

Massage or skin 

15 drops in 50ml carrier oil 
or lotion; for single 
application, mix 2-3 drops in 
one teaspoon! ul of carrier oil 
or lotion 

Room freshener: 

10-12 drops with water in a 
small bowl by radiator. For 
vaporiser, follow the maker's 
instructions. Put half a pint 
of water into a plant spray 
bottle with 10-12 drops 
essential oil, shake well and 
spray room. Sprinkle 
essential oil over pot pourri. 

Using oils safely 

Essential oils are extremely 
powerful and should always 
be used with care. Taking 
the following precautions 
will allow oils to be used 
safely and effectively: 

• If a customer is pregnant, 
advise her to only use oils 
under the guidance of a 
gualified aromatherapist 

• Never take oils internally, 
unless under medical 

• Epilepsy sufferers, 
asthmatics, those with heart 
conditions or any acute 
illness or condition should 
seek advice before using 
essential oils 

• Do not apply oils neat to 
skin, except when indicated 
for emergency first aid use. 

• If oil is accidently splashed 
onto skin, wash with plenty 
of water. If oil is splashed 
into eyes, flush with water 

Popular oils and their uses 

Essential oil 

Remedy for 



Headache, colds, 
burns and bites, 
ulcers, stress, 

Cheap and easily 


Skin conditions, 
digestive problems, 
urinary infections 

Do not use before 
sun exposure — 
can cause 


Insomnia, headache, 
dry skin, inflammation 



Headache, migraine, 
indigestion, heartburn, 
coughs and colds, 

Close eyes while 
inhaling. Not 
suitable for small 


Aids concentration, 
cellulite, improves 

Avoid during 


Calming aroma, aids 
PMS, sore throat, 
mood swings 

Fairly expensive 

Tea Tree 

Anti-bacterial, spots, 
burns, bites, cuts, skin 
disorders, athlete's 
foot, ulcers 


Ylang Ylang 

Depression, stress, 
high blood pressure, 
acne or oily skin 

Can be used as a 
perfume; cheaper 
alternative to 


Diarrhoea, varicose 
veins, oily skin, 
sweaty feet 

Good burning 

and seek medical help if 
pain persists 

• People with allergies or 
sensitive skin should always 
do a patch test for each oil 

• Keep oils well away from 
naked flame. 

Oils in pregnancy 

Much has been said about 
the dangers of using 
essential oils during 
pregnancy, when it is 
thought they may cross the 
placental barrier once in the 
bloodstream. Practising 
aromatherapist Michelle 
Rogues-O'Neil, who has 
recently launched her own 
Essential Therapeutics range 
of oils, has successfully 

assisted several women 
through pregnancy and 
labour using aromatherapy 
oils. But she agrees that it is 
not advisable for women to 
treat themselves — her 
advice is to go to a 

reputable, gualified 
aromatherapist (check they 
belong to a recognised 
aromatherapy association 
such as the AOC). 

Get trained 

Many manuf acturers of 
aromatherapy products offer 
training courses to pharmacy 
staff so that they will be 
better able to advise 

Tisserand Aromatherapy 
runs weekend aromatherapy 
seminars suitable for 
pharmacy assistants. The 
company supplies a 
comprehensive range of 
leaflets and books and has a 
dedicated consumer helpline 
which can also be used by 
pharmacy staff. The helpline 
number is; 01273 325666. 

Shirley Price 
Aromatherapy also runs 
weekend courses as well as 
longer courses, which are 
suitable for assistants. For 
more information contact the 
company's courses hotline 
on 01455 633231. 

For customers that are 
interested in learning more 
about aromatherapy, most 
adult education centres run 
evening or weekend 
courses. Your local library 
will have details. 

Further reading: 

• Practical Aromatherapy by 
Shirley Price (Thorsons) 

• The Art of Aromatherapy 
by Robert Tisserand (CW 



high quality pure essential oils 

Lothian Herbs have provided a competitive 
and efficient service for the last thirteen years. 
We extensively test our essential oils tor purity 

and select only the correct botanical species 
apprupnate lor aromatherapy. 

As aromatherapy has developed over the years 
we have expanded our range of products to 

meet the needs of current practice. 
For a complete list of aromatherapy products 
please contact us tor our latest trade price list. 

Lothian Herhs. I Pctfc 

nil Industrial Estate. Peffermill Road. Edinburgh. EH 16 5UY 
tax 031 652 0245 tel03l 661 L )S03 


OVER THE COUNTER 21 January 199 

'RODUCT INFORMATION: Presentation: Gelatin capsule containing an oil containing as active ingredients; Lcvomenthol Ph Etit 35.55mg, Chlorbuto] B.P. 2.25mg. Tcrpineol B.P. 66.6mg, Thymol B.P. 3. 1 5mg, Pumilio 
'ine Oil B.P. 1980 103.05mg, Pine Oil Sylvestris 9mg. Uses: For the symptomatic relief of nasal congestion and colds in the head. Dosage and Administration: Adults and children ovet 3 months; carefully sprinkle the 
ontents onto bedding or material, avoiding the possibility of skin contact. Alternatively, add to a pint of hot water and inhale vapour freely, Contra-indications, Warnings, etc: Karvol should not be used 
>y patients who are sensitive to any of the ingredients. Not recommended for children under 3 months of age. Avoid contact with eyes and prolonged contact with the skin. Do not take internally. Package 
Juanthies: Packs containing 1 or 20 capsules. RSP: Capsules 1 0s £1 .69, Capsules 20s £3.09. Legal Category; CSL Product Licence No: PL 0327/59 14. Crookes Healthcare Ltd, Nottingham NC2 3AA. 

lttle pi 

All children need warmth and affection, hut those 
with nasal congestion also need effective relief. 
That's what they yet from Karvol. It allows them to 
breathe easily throughout the night, and it does so 
gently, as there's nothing to swallow or rub 
onto a child's chest. Simply dab the pre 

measured dose on a handkerchief tied to the cot, and 
the natural vapours of pine, menthol and cinnamon 
effectively unblock stuffy noses. 

That means a good night's sleep for children and their 
parents - and keeps Karvol in front as the most 
1 recommended nasal decongestant for children. 

Gently does it 



! : ! 

'Breathing a vein' to treat diabetes 

Probably the first written 
reference to diabetes is in an 
ancient Egyptian papyrus 
dating from around 1550 BC. 
Diabetes is described as a 
'too great emptying of urine' 
and, more poetically, as 
being 'like the River Nile 
between the thighs'. The 
recommended remedy is a 
diet consisting of wheat 
grains, grapes, honey and 

Other prescriptions include 
myrtle pounded with 'viscous 
fluid' and applied to the 
penis; toasted beans in oil, 
also for topical use; and a 
compound of marsh water, 
pigeon nuts, beer, cucumber 
leaves and dates, mixed, 
strained and taken tor four 

The term 'diabetes' itself 

comes from the Greek word 
meaning 'siphon' or 'pass 
through', referring to the 
severe diuresis associated 
with the uncontrolled form 
of the disease. 

The Middle Ages 

Few significant advances in 
our knowledge of diabetes 
were made during the 
Middle Ages. One man 
however, stands out. 

Aureolus Philippus 
Theophrastus Paracelsus 
Bombast ab Hohenheim 
(1491-1541), known more 
simply as Paracelsus, 
probably performed the first 
chemical experiments into 
diabetes. On evaporating the 
urine of a diabetic, he 
discovered that one 
'measure' yielded four 

Around one million people in England and 
Wales suffer from diabetes, both insulin 
and non-insulin dependent. Yet it is only 
since the beginning of this century that 
effective management of the disease has 
been possible with insulin and oral 
antidiabetic agents. Read on to discover 
how diabetes was managed in times past 

ounces of 'salt'. Apparently 
he freguently tasted the 
urine of his patients but did 
not realise that diabetics' 
urine was sweet, not salty. 

The 17th century 

Although the sweetness of 
diabetic urine was probably 
first recognised in India, the 
first Westerner to record this 
fact was Thomas Willis of 
Oxford University. 

He believed that diabetes 
was caused by poor hygiene, 
anxiety and over-indulgence 
in alcohol. His recommended 
treatment was dietary — 
milk, rice and starchy foods 
— and thus he unwittingly 
instituted the first high- 
carbohydrate under-nutrition 

He also favoured therapy 
with antimony and opium, 
the latter being a tradition in 
diabetes treatment that, ovei 
the years, was to turn many 
patients into addicts. 

Dietary cures 

The first systematic 
carbohydrate restriction diet 
was introduced by John 
Rollo, a surgeon general in 
the British Army during the 
1790s. Although it gradually 
fell into disrepute, its main 
features — carbohydrate 
restriction and high protein 
and fat content — continuec 
to be used. 

In contrast an opposing 
school of thought grew up - 
the so-called 'carbohydrate 
cures' — in which the 

Daniel Lambert, The Fat Man of Leicester. Diabetes wa 
linked to diet as early as the 1 7th century 

OVER THE COUNTER 21 January 19 

Some 50 per cent of adult Pima Indianshave NIDDM 

patient was instructed to 
take little else but 
carbohydrate. It may come 
as a surprise to learn thai 
genuine improvements were 
recorded with these diets, 
probably as a result ol 
associated undei -nutrition. 

Before the discovery of 
insulin the main method of 
treatment of diabetes was 
starvation, as popularised by 
Dr Frederick Allen. The 
average life expectancy of 
patients on the Allen diet 
was three to four years and 
they generally died oi 
starvation, rather than 
diabetes. Allen was the first 
to admit this but usually 
pinned the blame on 
previous doctors for being 
too soft-hearted! 

Matthew Dobson, a 
physician working at the 
Liverpool Infirmary, 
repeated Paracelsus's 
experiment of evaporating 
down urine and showed that 
the 'salt' left behind was 

The English physician, 
Thomas Cawley, was the 
first person to connect 
diabetes with lesions in the 
pancreas. Until then, 
diabetes had often been 
viewed as a disease of the 

Discovery of insulin 

Working in Toronto, 
Frederick Banting, the 
anadian orthopaedic 
surgeon, and Charles Best, 
then a medical student, 
tested Banting's theory that 
digestive enzymes produced 
by the acinar tissues in the 
pancreas might prevent 
extraction of insulin. 

Using a series of 
laboratory procedures they 
obtained pancreatic extract 
which did not contain 
pancreatic digestive enzymes. 
The ground-up extract was 

jected into a comatose dog 
lamed Marjorie. She 
ecovered consciousness to 
become the first animal to 
eceive insulin. 

The first person to receive 
nsulinwas 14 year old 
eonard Thompson, who 
nade a remarkable recovery 
fter starting insulin on 
anuary 11, 1922. 
Banting won the Nobel 
rize for Medicine in 1923 
nd shared the prize with his 
tudent co-worker. 

Vartime diet 

>unng the First and Second 
^orld Wars the death rate 
om diabetes plummeted, 
•rrelating closely with 
eriods of food rationing, 
his effect seemed to be 
mfined to people with 
an-insulin dependent 
labetes (NIDDM). 
The Second World War 

revolutionised the whole 
concept of diabetic diet. 
Before the war, newly 
diagnosed diabetics were 
given a rigid diet sheet and 
many stuck to the same 
menu day after day. 

With rationing this was no 
longer feasible, and tor the 
first time, people with 
diabetes were eating the 
same food as the rest of the 
family and adjusting their 
treatment accordingly. 


In 1942, during the German 
occupation of France, the 
first oral hypoglycaemics 
were discovered by 
accident. There was an 
outbreak of typhoid in 
Montpellier and Marcel 
Jambon, a doctor in the 
isolation hospital, decided to 
try out a new sulphonamide. 

The drug seemed to work 
against typhoid, but 
unfortunately produced 
disastrous results in two out 
of ten patients. Intravenous 
injection of glucose revived 
some patients and it 
transpired that the cause of 
death was hypoglycaemia. 

August Loubatiares, also 
at Montpellier, found that 
insulin, bound with certain 
zinc protamines, also caused 
hypoglycaemia. It occurred 
to him that there might be a 
parallel between the effects 
of the sulphonamide and 
protamine zinc insulin. 

He confirmed Jambon's 
findings by conducting 
animal experiments leading 
to the the first commercial 
sulphonylureas, carbutamide 
and tolbutamide, in the 


In 1914 it was found that 
removal of the parathyroid 
in experimental animals led 
to a reduction in blood 
sugar. This was due to a rise 
in blood guanide levels. 

Although guanidme itself 
was too toxic for human use, 

in 1926 the molecule was 
altered to retain its 
hypoglycaemic action while 
eliminating the toxic effects. 
This compound, known as 
Synthalin, was briefly 
marketed but soon 
abandoned because of 
side-effects. However, it 
does carry the distinction ol 
being the tirst oral 
antidiabetic agent. 

Interest waned in Ibis 
category with the 
widespread use of insulin 
but was rekindled following 
the success of sulphonylureas. 
The first biguanides — two 
guanidine derivatives joined 
together — were marketed 
in 1957. The only biguanide 
widely available today is 


Sulphonylureas and 
biguanides, together with 
diet, remained the only 
available forms of oral 
therapy until very recently. 

Carbohydrate digestion 
principally occurs in the 
upper third or so of the small 
intestine. The final common 
pathway in this process is the 
cleavage of non-absorbable 
oligosaccharides to more 
absorbable monosaccharides 
by a series of enzymes called 
alpha- glucosidases, present 
on the microvilli that make 
up the 'brush border' at the 
mucosal wall of the small 

In the late 1960s, Professor 
Walter Puis, a researcher at 
the Institute of Pharmacology 
at Bayer, suggested that 
competitive inhibition of 
these enzymes would delay 
carbohydrate absorption 
following a meal, leading to 
a reduction in blood sugar 
following a meal with, it was 
hoped, a secondary 
improvement in basal blood 
glucose levels. 

A series of possible 
compounds was isolated 
from Actinomycetes spp, the 
most promising of which was 

acarbose. ( llinical research 
showed that acarbose nol 
only significantly reduced 
postprandial hyperglycemia, 
but also fasting blood 
glucose levels, without 
causing weight gain oi 

Acarbose was patented in 
1973 and launched in (he 
UK undo! the I rade naini • 
Glucobay in 1993. It is 
licensed tor the treatment of 
NIDDM in patients 
inadeguately controlled by 
either diet alone or 
conventional oral agents. 

Around the world 

Non-insulin dependent 
diabetes is the 'hidden 
diabetes' or 'the disease of 
civilisation'. Nine-tenths of 
all diabetics are NIDDM. It 
is also believed that loi 
every diagnosed NIDDM 
patient, there is anothei yet 

In the last century the 
prevalence of this disease in 
American Indians was 
among the lowest recorded 
in any ethnic group. Since 
the Second World War, 
though, prevalence rates 
have risen to a remarkable 
degree among some tribes. 

The most famous example 
is that of the Pima Indians of 
Arizona, who now have the 
highest reported prevalence 
of NIDDM in the world, 
some 50 per cent ol adults 
being affected. 

Up to 8 per cent of the one 
million or so Indo-Asians 
living in Britain have 
diabetes. NIDDM has a 
strong familial basis and 
may be related to insulin 
resistance which is more 
common in Indo-Asians. 
Diabetes in first generation 
UK Asians could be as a 
result of their complete 
change in lifestyle on 
moving from rural India to 
urban, sedentary and 
overweight Britain. 
• This article is a summary 
ot The History of Diabetes 
Exhibition, compiled and 
sponsored by Bayer pic, 
which is touring the UK and 
Europe as part of a series of 
meetings which aim to raise 
the awareness of non-insulin 
dependent diabetes. 

In 1995 the Exhibition can 
be seen at the following 
venues January 26, 
Wembley Arena, London; 
February 9, Gosforth Park, 
Newcastle; February 16, NE 
Thames region (venue to be 
confirmed); February 23, 
Aintree Racecourse, 
Liverpool; March 2, SW 
Thames Region (venue to be 
confirmed); March 9, Royal 
Marine Hotel, Dublin; 
April 20, Maidstone, Kent; 
April 27, Central TV 
Studios, Nottingham. 


January 1995 

1 7 

Pain manaa 

Every day in your pharmacy many customers will buy painkillers (analgesics) or 
ask for advice about painful conditions. With a huge range of products available, 
how do you know which ones to recommend? Trudy Thomas, a community locum 
pharmacist and a training officer at the National Pharmaceutical Association, 

gives some guidelines 

What is pain? When we 
suffer pain it is our body's 
way ot warning us that 
something is wrong. In many 
cases we know what the 
problem is. For example, if 
we feel achy due to a cold, 
we will simply want to 
relieve the symptom of pain 
until the cold has gone. Pain 
that doesn't go when over 
the counter products are 
tried, or that keeps coming 
back, must not be ignored. 

Customers will use lots of 
different ways to describe 
pain: burning, stabbing, 
sharp, aching, twinging, 
throbbing, sore, etc. 

Everyone feels pain 
differently. What is difficult 
for assistants and pharmacists 
alike is deciding just how 
bad a person's pain really is. 

Questions to ask 

When a customer complains 
of pain you have to ask 
yourself two questions: 

1. What is causing this pain? 

2. Is there a possibility that 
something more serious 
could be wrong? 

In order to answer 
yourself, you will in turn 
need to ask the customer the 
2WHAM guestions. 

• Who is the person 
suffering the pain? 
Remember, it may not be the 
person asking for advice. 

• What are the symptoms? 
In this case what is the pain 
like, where is it? You might 
ask if the pain moves, if it is 
getting worse and so on. 

• How long has the pain 
been present? 

• Has the customer taken 
any action so far? 
Perhaps they have tried a 
painkiller, if so which one 
and has it worked? Some 
customers may already have 
visited the doctor. 

« Does the customer take 
any other medicines? 
Depending on the answers 
you get to your questions, 
you may need to refer to the 

When to refer 

The following groups of 
patients should be referred: 

• those under eight years old 

• pregnant or breastfeeding 

® the elderly 

• those taking other 


You should also refer 
anyone with pain which: 

• is severe 

• has started suddenly for no 
apparent reason 

• keeps coming back 

• isn't helped by over the 
counter remedies 

• is combined with other 
worrying symptoms, such as 
shortness of breath, bleeding, 
unexplained loss of weight. 

Check your pharmacy 
protocol to see if there are 
other cases that your 
pharmacist wants referring. 


Over the counter products 
for the relief of pain are 
based on four main 


• Aspirin 

• Paracetamol 

• Ibuprofen 

• Codeine. 


This is the most traditional of 
all the painkillers. It is 
especially good at killing 
pain where inf lammation is a 
problem; for example, back 
ache. It is also good for 
taking down temperature, 
which might accompany the 
aches and pains of colds and 

Many people are unable 
to take aspirin, however. It 
should be avoided in: 

• children under 12 

• asthmatics 

• people allergic to aspirin 

• those with stomach ulcers 
now or in the past 

• those on certain 
prescription medicines, eg 

Many people are allergic 
to aspirin. It can cause 
anything from a mild rash to 
death in some rare cases. 
People who are asthmatic 
may have an asthma attack 
after taking it. 

Aspirin can cause stomach 
problems. To reduce these 
effects it should be taken 
with or after food and you 
must advise customers of 
this. The effects on the 
stomach are much worse for 

Continued on p20 ^ 


how big 




The biggest. In fact, 74% of all 
headaches are Tension Headaches." 
Which, when you think about the 
pressure people are under today, 
makes sense. 

What also makes sense, is 
to recommend a specific Tension 
Headache remedy strai g ht awa y. 
And the one to recommend is 

There is no more effective 
OTC treatment for your patients. 
Uniquely formulated for Tension 
Headache, Syndol contains the 
powerful analgesic combination of 
'aracetamol, Codeine and Caffeine, 
plus Doxylamine Succinate to ease 
muscle tension and bring fast relief 
a clinical study showed that in 97% 
)f Tension Headache attacks, Syndol 
started to work within 30 minutes). 

It is a Pharmacy medicine, is 
itrongly supported, creates extra- 
ordinary loyalty, and powerful word 
jf mouth recommendation. 

Get the benefit. Display well, 
ecommend at once, and above all 
lon't get caught out of stock. That's 

(1) National Headache Survey Gallup 1993 

Vou can't recommend 
more powerful relief. 

Paracetamol Codeine Phosphate 
Doxylamine Succinate Caffeine 

INFORMATION FOR PHARMACISTS: Each tablet contains Paracetamol BP 450mg. Codeine Phosphate BP 10mg. Doxylamine Succinate USNF 5mg, Caffeine BP 30mg USES: Treatment of 
mild to moderate pain and as an antipyretic Symptomatic relief of headache, including muscle contraction or tension headache, migraine, neuralgia, toothache, sore throat, dysmenorrhoea, 
muscular and rheumatic aches and pains and post-operative analgesia following surgical or dental procedures DOSAGE AND ADMINISTRATION: Adults and children over 12 years 1 or 2 
tablets every 4-6 hours as needed. Maximum 8 tablets in 24 hours Not recommended in children under 12 years CONTRA-INDICATIONS, WARNINGS ETC.: Contra-mdications Idiosyncrasy 
to any of the ingredients Precautions: May cause drowsiness If affected, do not drive or operate machinery No data available in pregnancy avoid use Side-effects Drowsiness or 
dizziness, mild constipation, agranulocytosis rarely. Overdose Paracetamol overdose can cause liver and kidney necrosis Immediate medical referral is essential LEGAL CATEGORY: P CD 
(Section 5) (not prescribable under NHS) PRODUCT LICENCE NUMBER: PL4425/0018 PACKAGE QUANTITIES, PRICE: Pack of 10 tablets C1 65 20 tablets £2,85 50 tablets £6 08 DATE OF 
PREPARATION: November 1994 Full prescribing information is available from licence holder Marion Merrell Dow Limited, Lakeside House. Stockley Park, Uxbridge, Middlesex UB11 1BE 

Continued from pi 8 

anyone who already has a 
stomach problem, eg an 

Aspirin is not suitable for 
the under 12s because it can 
cause a rare but serious 
condition called Reye's 


Ibuprofen is also good at 
reducing inflammation. It is 
especially good at treating 
period pain, too. 

It is, however, related to 
aspirin and many of those 
who cannot take aspirin will 
not be able to take ibuprofen 
either, eg asthmatics. It can 
also have an effect on the 
stomach and should "be 
taken with or after food. 

Until recently children 
under 12 were unable to 
take ibuprofen, but now a 
product is available in a 
syrup form for children over 
a year old. 


Paracetamol is a good 
analgesic, but is not as good 
at taking down inflammation 
as aspirin or ibuprofen. At 
the suggested dose it causes 
few side-effects and can be 
taken by children over the 
age of three months. (There 
is a special dose for 
two-month-old babies after 


Taking too much 
paracetamol can damage the 
liver and is very dangerous. 
A problem arises because 
paracetamol is in so many 
products, both over the 
counter and on prescription, 
and for this reason it is 
important to point out to 
customers if the product they 
are buying contains 


Codeine and its stronger 
relative, dihydrocodeine, are 
not available on their own 
over the counter, but are 
combined with one or more 
of the other painkillers to 
make a stronger product. It 
is only suitable for adults, 
but is best avoided in elderly 
customers as it can cause 


Have a look at the packets 
of painkillers that you stock. 
What other ingredients do 
they contain? 

Caffeine is often included 
to help the person in pain 
feel more awake and 
generally brighter. In most 
cases, however, a cup of 
coffee will contain more 
caffeine than many of these 

Doxylamine is an 

antihistamine and the fact 
that it causes drowsiness 
makes it useful for people 
with a tension headache. 

Cyclizine and buclizine 
are also antihistamines, and 
are mainly used for their 
ability to reduce sickness. 
They are particularly useful 
for migraine headaches, but 
again cause drowsiness. 

Misuse of painkillers 

Many people misuse 
painkillers, because they are 
not aware how powerful 
even over the counter 

remedies can be. Many 
think that because two 
paracetamol tablets cured 
their headaches before, 
three this time will make the 
headache vanish even 
quicker. This is untrue and 
very dangerous. 

It is also the case that 
some people are addicted to 
analgesics, so watch out for 
customers buying large 
quantities or purchasing on a 
regular basis. Check your 
pharmacy protocol for how 
best to deal with these 

Quick analgesic quiz 

From memory try to complete the chart below, then check 
your answers using the products on your shelves. We've 
done the first one for you. 

Ingredient/ Paracetamol Aspirin Ibuprofen Other 

Solpadeine X Caffeine 
tablets Codeine 






Anadin Extra 

Nurofen Plus 

Nurofen Plus. 

Ibuprofen BP. Codeine Phosphate BP. 

Product Information: Each tablet contains ibuprofen BP 
200mg and codeine phosphate BP I2.5mg. Indications: 

Effective in the relief of migraine, headaches, neuralgia, dental 
pain, dysmenorrhoea, rheumatic and muscular pain, backache, 
fevenshness, symptoms of cold and influenza Dosage and 
Administration: Adults and children over 1 2 years: initial 
dose 2 tablets taken with water, then, if necessary, I or 2 
tablets every 4-6 hours. Do not exceed 6 tablets in 24 hours. 
Precautions and Warnings: As with some other pain 
relievers, Nurofen Plus should not be taken by patients with a 
stomach ulcer or other stomach disorders or hypersensitivity 
to ibuprofen or codeine. Patients receiving regular medication, 
asthmatics, anyone allergic to aspirin, and pregnant women 
should be advised to consult their doctor before taking 
Nurofen Plus, In normal use, side effects are very rare, but may 
occasionally include dyspepsia, gastrointestinal intolerance and 
bleeding, constipation, nausea, skin rashes, depending on 
dosage and individual susceptibility. Not recommended 
for children under 12. If symptoms persist for more than 
7 days, patients should be advised to consult their doctor. 
Product Licence Number: PL0327/0082 Licence 
Holder: Crookes Healthcare Ltd,, Nottingham 
NG2 3AA Legal Status: P. Price: 1 2's 
£1.85; 24's £3.39, Date: |anuary 1995 


Topical analgesics 

Many customers like to treat 
their muscular aches and 
pains with a cream, spray or 
rub. These are examples ol 
topical analgesics. 

Topical mi', ins applied 
directly to the area that is 
affected. Many of these 
products leave the area 
feeling, warm and massaging 
them into the skin can bring 

Products contain mi] 
ibuproten and ketoprofen, 
until recently only available 
on prescription, can now be 
sold over the counter. It is 
likely that in the next year 
more anti-inflammatory 
products will follow. 

Occasionally topical 
products can cause skin 
irritation and they should not 
be applied to broken skin. 
Because topical products can 
cross the skin layers into the 
blood, people who cannot 
take ibuprofen by mouth 
must be very careful about 
using anti-inflammatory 
creams and ointments. 

Check with your 
pharmacist on how he or she 
wants you to deal with 
reguests for these medicines. 

Types of pain 

There are many different 
types of pain. 

• Headache 

• Migraine 

• Sinusitis 

• Stomachache 

• Period pain 

• Toothache 

• Muscular pains 

• Strains, sprains and 

I'm sure you can think of 

Lei's have a look in more 
detail at some of these types 
of pain that can be treated 
with over the countei 


One of the commonest types 
of headache is tension 
headache. This can start in 
the neck or back of the head 
and result in a band of 
tightness above the eyes. It 
is more common in women 
and is linked to stress. 

True migraine headaches 
usually affect one side of the 
head only. The sufferer will 
often experience strange 
sensations before the 
headache starts and may see 
flashing lights. Many attacks 
make the sufferer feel or be 
sick. You should refer 
anyone who is suffering 
what sounds like a migraine 
headache for the first time to 
your pharmacist. 

Continued on p23 ► 

The proven power of ibuprofen. 
The established power of codeine. 
By bringing them together in 
a unique combination, new 
Nurofen Plus gives you an ideal 
recommendation when extra - 
strength pain relief is called 

for: migraine, tension headache, 

cramping period pain, post- 
operative dental pain, neuralgia, 
sciatica, lumbago and rheumatic pain. 




The new way 
to bring a child's 
fever down 

Product: Junifen Suspension: 
5ml contains 100mg ibuprofen 
BP Indications: For the 

reduction ot fever and relief of 
mild to moderate pain in children 
between the ages of 12 months 
and 12 years. Dosage and 
administration: Children 
1-2 years: One 2.5ml spoonful 
3-4 times a day, children 
3-7 years: One 5ml spoonful 3-4 
times a day, children 8-12 years: 
Two 5ml spoonfuls 3-4 times a 
day. Do not exceed 4 doses in 
any 24 hours Precautions and 
warnings: Junifen should not 
be given to children with stomact 
ulcers or other serious stomach 
disorders. Patients receiving 
regular medication, asthmatics, 
anyone allergic to aspirin and 
pregnant women should be 
advised to consult their doctor 
before taking Junifen Not 
recommended for children unde 
the age of one year or weighing 
less than 7kg (161b). If symptom, 
persist for more than 3 days 
patients should consult their 
doctor. Adverse effects 
reported include: dyspepsia, 
gastrointestinal intolerance and 
bleeding and skin rashes. Less I 
frequently, thrombocytopenia ha: 
occurred Product licence 
number: PL 0327/0077 
Licence holder: Crookes 
Healthcare Ltd., Nottingham NG 
3AA. Legal category: P. Pricel] 
Junifen Suspension: 100ml £2.6f 
1. Kauffman R.E., etal., AJDC, 
1992, 146, 622. 2. SidlerJ, 
etal., Brit. J. Clin. Pract , Supp 
70, 44, (8), 1990: 22. 3. Walso; 
PD., etal, Clin. Pharmacol. Theii 
46, 1989: 9. 4. Walson RD., 
J, Clin. Pract., Suppl, 70, 44, (8t| 
1990; 19. 5. Lohokare S.K. andj; 
Jog V., J, Pain and Symptom 
Management, 6, (3), 1991; 1581 j 
6. Schachlel B.R and Thoden j 
W.R., J. Pain and Symptom: 
Management, 6, (3) 1991; j 
159. 7. Data on file, Crookes j 
Healthcare Ltd. 1 

At last, you can recommend the antipyretic and 
analgesic benefits of ibuprofen for children. 

Junifen's antipyretic action is greater 1 2 , longer 
lasting' Xi and more rapid 24 than paracetamol's. 

its efficacy in relieving pain is proven in years 
of prescription use 56 . 

And it's as well-tolerated as paracetamol 7 . 

Free of sugar and colour, the orange flavoured 
Junifen suspension is the one to recommend for 
childhood pyrexia and pain. 

Now you have a choice for fever 
and pain in children 

W A V A I L 




Continued from p2 1 

For regular sufferers the 
time to take painkillers is as 
soon as the warning 
sensations start, before the 
headache actually begins. 

products are best avoided 
because they can make the 
sickness of migraine worse. 

Period pain 

Many women suffer from 
cramping stomach pains just 
before their period starts, 
and painkillers, particularly 
ibuprofen, can be effective. 

Tooth pain 

The pain of teething may 
cause young children much 
distress. Paracetamol and 
ibuprofen in liguid form can 
help. Some products also 
include an antihistamine to 
aid sleep. 

Anyone with toothache 
needs to see their dentist, 
but a strong painkiller, such 
as paracetamol and codeine, 
can be helpful until they can 
get an appointment. 


Congestion in the sinuses, 
the passages that lead to the 
nose, often accompanies a 
cold and can cause a 
headache over the eyes. 
Combination products of 
decongestants and 
painkillers can be helpful, 
but remember to check if 
customers are taking any 
other medicines. 

Muscular pain 

Ibuprofen and aspirin, with 
their anti-inflammatory 
effects, are useful for 
muscular aches and pains, 
and customers may like to 
try topical products. 

Warmth generally is good 
for muscular aches, although 
bruises, twisted ankles and 
other types of sudden injury 
will often be helped by a 
cold compress and the 
raising of the injured part. 

Check with your 
pharmacist it you are unsure 
how best to treat a strain, 
prain or muscular problem. 

Your role 

Counter assistants have an 
important role to play in 
helping customers in pain. 
There are so many 
analgesics on the market 
that you could never be 
expected to know them all, 
but get to know a small 
number well. ( Why not have 
p go at our guick guiz to see 
jf you can remember what is 
in some popular analgesics.) 

Point out to customers the 
main ingredients of the 
painkiller as you sell it. By 
Asking guestions you can 
dentify customers that need 
o see your pharmacist. 


Osteoporosis: the 
silent killer 

many of us fncy don 

men, will have an o 
reach flhe age of € 
disease, yet we can 

Osteoporosis creeps softly 
into victims' lives, eating 
away at their bones for 
many years before it is 
diagnosed. In most people, 
the symptoms are so tew 
that the disease only 
becomes apparent when a 
bone gets broken after a 
minor fall. 

However, those who are 
severely affected suffer from 
back pain and may also lose 
height and develop a curved 
back, as the bones in their 
spine weaken and crush 
together. This may sguash 
their chest cavity and put 
pressure on their bladder, 
causing breathing difficulties 
and incontinence. 

Bone metabolism 

From the outside, 
osteoporotic bones look 
normal, but inside, the rigid 
honeycomb structure has 
broken down to reveal large 

Like all living tissue, bone 
is constantly being replaced 
and renewed by its cells, 
which use calcium from the 
diet to make bones dense 
and strong. Normally, your 
bones grow until you reach 
age 30, when your bone 
density reaches a maximum 
— your 'peak bone mass'. 

After about age 35, your 
bone tissue starts to lose 
calcium — faster than it is 
replaced — so you may get a [ 
little weaker and your bones ~ 
may become more brittle. 

Once bone is lost, it can't o 
be replenished, but if your 
peak bone mass is high, the j 
bone loss won't be so 
noticeable. Peak bone mass i 
is partly genetically 
controlled, so osteoporosis 
often runs in families. 

Men v women 

Men naturally have a higher 
bone density than women to 
start with, so it's not 
surprising that they are less 
prone to osteoporosis. But 
there is another culprit 
causing the high proportion 
of women sufferers: the 

Both men and women lose 
about 0.4 per cent of their 

January 1995 

bone mass each year after 
they reach age 35, but while 
this rate stays steady in men 
as they get older, it increases 
dramatically in women. 

They lose 2 per cent of 
their bone mass in each of 
the first five years after 
menopause (which starts 
around the age ot 50), and 
then 1 per cent for every 
year after that. 

oestrogen nuunlciins calcium 
levels in the body, so once 
oestrogen supplies (let line, 
the bone mass falls. 

Replacing the lost 
oestrogen, in the form ot 
hormone replacement 
therapy (HRT), is the most 
common treatment and 
preventative measure in 
women under 65, especially 
those with exceptionally thin 

Women who have an early 
menopause, perhaps 
because of a hysterectomy, 
can lose up to half their total 
bone mass before they reach 
the age of 70. 


When women reach 
menopause, their ovaries 
start to wind down and the 
output of oestrogen is 
reduced. Normally, 

bones or a family history of 

You can take HRT in pills, 
patches or implants and 
treatment can be 
tailor-made to suit your 
needs, although it isn't 
suitable for everyone. Some 
forms, for women who still 
have a womb, contain 
progesterone to reduce the 

Continued on p24 


Getting enough? 

The National Osteoporosis 
Society suggests that 
children between seven 
and 12 years of age should 
get 800mg of calcium a 
day; teenagers between 13 
and 19, men between 20 
and 60 and women over 45 
on HRT should get 
l.OOOmg; pregnant and 
breastfeeding mothers 
should get l,200mg; and 
pregnant and nursing 
teenagers and men and 
women over 45 should get 

The Department of 
Health's recommendations 
are slightly lower, but 
recent research suggests 
that the higher levels are 
more beneficial. Be careful 
though, as too much 
calcium (over 2,000mg a 
day) may cause 
constipation, nausea and, 
more seriously, kidney 

Continued from p23 

chances of developing 
endometrial cancer. 

Taking HRT for over five 
years, starting soon after 
menopause, cuts the risk of a 
fracture by about 50 per cent 
and slows bone loss to about 
0.5 per cent a year. 

In addition to this, HRT 
eliminates the usual 
menopausal symptoms, 
including hot flushes and 
night sweats, which make 
many women's lives a 

Although HRT doesn't 
cause many side-effects, 
initial nausea and breast 
tenderness are common and 
a few women suffer from 
severe headaches as a result 
of the treatment. 

Role of testosterone 

In 20 per cent of men, low 
testosterone levels play a 
part in the onset of 
osteoporosis, although 
testosterone's exact role in 
maintaining bone levels is 

It seems that men who are 
born with reduced 
testosterone levels have 
reduced bone formation, 
although this can be treated 
efficiently with testosterone 

Men who develop 
testosterone deficiency in 
later life have increased 
bone breakdown. 
Preliminary research 
findings suggest that 
testosterone replacement is 
also benef icial in these men. 

But it does have its 
side-effects, such as a raised 
blood pressure and, in high 
doses, an increased sex drive 
and aggressive behaviour. 


Contributing factors 

Not all post-menopausal 
women develop osteoporosis 
and only a few male 
sufferers have reduced 
testosterone levels, so there 
must be other factors 
involved. Too much alcohol 
and tobacco, the effects of 
certain drugs (especially 
corticosteroids), too little 
exercise and a lack of 
calcium all seem to 
contribute to osteoporosis. 

Don't panic 

If you think you're at risk, 
don't panic — there's a lot 
you can do to minimise bone 
loss, and the sooner you 
adapt your lifestyle the better. 
• Drink sensibly 

Too much alcohol decreases 
your ability to absorb 
calcium and increases the 
risk of falls. Don't exceed the 
recommended guidelines of 
14 units per week for 
women and 21 units per 
week for men — one unit is 
about half a pint of beer, a 
glass of wine or a singie 
measure of spirit. 

• Quit smoking 
Tobacco is harmful to bones 
and encourages an early 
menopause. Not only will 
you reduce the risk of 
becoming an osteoporosis 
sufferer, you wifl also protect 
yourself against lung cancer 
and heart disease. 

• Take more exercise 
This wifl strengthen your 
bones and improve your 
balance and coordination. 
You don't have to run 
several miles every day — a 
brisk walk for 20 minutes, 
three times a week, should 
be sufficient. 

In fact, if you exercise too 
vigorously you may do 
yourself more harm than 
good by disrupting your 
monthly cycle and reducing 
your oestrogen levels to 
danger point. 
• Calcium intake 
Make sure you get plenty of 
calcium in your diet, 
especially if you're pregnant, 
breastfeeding or over the 
age of 50. Vegans may also 
need extra calcium, as dairy 
products and oily fish are the 
best sources — one pint of 
milk contains just over 
l.OOOmg of calcium, the 
recommended adult daily 
intake. These foods are also 
high in vitamin D, which 
helps your body absorb 


At present, Didronel PMO 
is the only form of this drug 
licensed to treat 
osteoporosis, and it must be 
taken for 14 days followed 
by a calcium supplement for 
76 days, over a period of 
three years. Stronger forms 
of this drug are currently 
being assessed. 

• Anabolic steroids build up 
muscles and bones, so they 
are especially helpful in the 
elderly. But they have 
limited use, as they cause 
severe acne and the growth 
of facial hair, and may 
increase the risk of liver and 
heart problems. 

• Fluoride. The effect of 
fluoride on bone is 
controversial, as low levels 
reduce the number of 
fractures, but high levels 
seem to increase them. 
Getting the right dose is 
important, so only a few 
specialist centres offer this 

• Calcitonin is the only 
treatment that can relieve 
the pain suffered by many 
patients with osteoporosis. 
A hormone which inhibits 
the cells that break down 
bone, calcitonin is also an 
effective painkiiler with few 
side-effects. At present, it is 
oniy available in an injected 
form, but nasal sprays and 
rectal suppositories are 
currently being tested. 

• Alternative painkillers 
Other ways to relieve pain 
include hot water bottfes 
and cold ice packs, simple 
painkillers and hydrotherapy 
(physiotherapy in a pool 
heated to 98°F to relax 
muscles and increase 
mobility). Acupuncture and 
electrotherapy may also be 

calcium, although we get 
most of the vitamin D we 
need from natural sunlight. 

Elderly people are 
especially at risk from 
calcium deficiency, as they 
don't absorb vitamins and 
minerals very efficiently. If 
you don't get enough 
calcium or vitamin D you 
may need to take 

Di ug therapy 

Calcium may help prevent 
osteoporosis, but it can't 
treat it — for that, you need 
HRT, testosterone or other 
prescribed medication. 
• Cyclical etidronate is a 
non-hormonal treatment for 
women with osteoporosis of 
the spine and may also be 
effective in men, aithough 
there has been little research 
in this field. It sticks to the 
outside of bone, preventing 
the cefls which break down 
bone from working 


ff you do suffer from 
osteoporosis, you're not 
alone. The Nationai 
Osteoporosis Society is a 
charity which funds research 
into the disease, as well as 
providing help for sufferers 
and their families. National 
Osteoporosis Society, PO 
Box 10, Radstock, Bath BA3 
3YB. Tel: 01761 432472 or 
call its heipline on 01761 

Handy hints 

• Minimise the risk of a 
fall by removing loose 
carpet, securing down rugs 
and wires, and keeping 
your rooms well-lit. 

• If children don't like 
milk, be inventive. Give 
them milkshakes or hot 
milky drinks and introduce 
more cheese and milk into 
your cooking. 

OVER THE COUNTER 21 January 1< 

Pharmacy in the 
primary healthcare 


Jeremy Clitherow 
healthcare tear 

What do we mean by 
primary healthcare' and the 
primary healthcare team'? 
In the most basic terms, 
primary healthcare refers to 
the services delivered in the 
community sector, and 
'secondary healthcare' to 
those supplied by hospitals. 

Not so very long ago, 
primary healthcare services 
were restricted to those 
provided outside hospital by 
family doctors, the local 
dentist, the community 
pharmacist and the optician 
on the High Street. 

Single-handed or 
two-handed general 
practices were the norm. 
Group practices and modern 
health centres were unheard 
of. The common factor was 
that the various professionals 
all worked in isolation. 

Nowadays, multipractice 


centres are commonplace, 
particularly in the case of 
new developments. The 
revised health service has 
recognised the added value 
of incorporating the skills 
and knowledge of a much 
wider group of health 
professionals into a unit, 
hence the multipurpose 
primary healthcare team. 

The nucleus of the team 
will always be the GP's 
surgery. Radiating out from 
there will be the support 
staff, each a valuable 
member in his or her own 

It is rewarding to read the 
Government's own words in 
describing the primary 
healthcare services. "These 
services are the frontline of 
the National Health Service. 

ns what the primary 
staff can make an 

On an average working day, 
in excess of 1.2 million 
people use them. The 
Government spends over 
£5,000 million each year to 
purchase them." 

These are not just words. 
The NHS is committed to 
developing and encouraging 
the formation of healthcare 
teams. The first positive 
incentive was the removal of 
the restriction on the types 
and numbers of staff a GP 
was allowed to employ. The 
next was to embark upon an 
ambitious scheme of 
investment in GP surgery 
premises right across the 

You have only to walk into 
the average GP's surgery 
today and compare what 
you see with what was 
available only a few years 
ago to realise that the Health 

Service is really advancing 

A common lealure in 
many surgeries now is the 
large picture frame showing 
photographs of all the stall 
mi'iiibiMs diid <|iviii<| their 
job titles. There are practice 
managers, practice nurses, 
receptionists, administrative 
and clerical stall members, 
chiropodists, community 
dentists, health visitors, 
community nurses, 
mid wives, physiotherapists, 
social workers, 
psychologists, dieticians, 
counsellors, specialist clinic- 
nurses, opticians and even 


The Secretary of State for 
Health, Virginia Bottomley, 
and the chief executive of 
the NHS, Alan Langlands, 
have one vitally important 
message for us all. That the 
NHS is a team, and one with 
many players. Different 
players bring different skills 
and strengths. 

The cumulative skill-mix 
of any team will always be 
greater than that of its 
constituent members. 
Remember too 'They also 
serve ...' Everyone is 
valuable and everyone 
brings a worthwhile addition 
to the services available 
from the team. 

That's what we mean by 
the primary healthcare team. 

The answer is quite simple. 
They bring their particular 
training and expertise to the 
patient and widen the scope 
of the care available at the 

'Shared care' is the vogue 
term. The way it works is 
that the patient is seen and 
their needs, be they medical, 
surgical, physical or social, 
are assessed. They are then 
given care plans of one sort 
or another and despatched 
to the best informed and 
experienced member of the 
team tor implementation of 
the plan. 

In simple cases, the plan 
may be oral and take the 
form of an advisory session 
and referral to, say, the 
practice nurse for a wound 
dressing. It could equally be 
a referral to a surgeon 
outside the primary 
healthcare team. Whatever 
is needed is provided. 

Practice leaflets are all very 
well, but will never match 
the speed and coverage of 
the spoken word. Call it 
village gossip if you like. It 
works. The more the 

Continued on p28 ► 


January 1995 

thought a cream wa| 

e perfect answer to thrush!' 

Doctors realise that women want the thrush more than anything else. Used 

quick, soothing relief a cream can inside the vagina, its so effective that 

provide. But they also know that, it treats just about all sufferers with 

while thrush may 

So why do 

cause external itching, 
the fungus that 
causes thrush lurks 

doctors prescribe 

pessaries? " 

one overnight treat- 
ment. The symptoms 
will start clearing 
immediately and will 

inside the vagina. Unless it's killed totally disappear within three days. 

there, the itch can come straight back. Meanwhile, in really bad cases, you 

That's why you should recommend can suggest that the woman use a 

an intravaginal treatment: Canesten 1 cream as well. But your first, and in 

pessary. It contains clotrimazole, most cases only, recommendation 

which doctors prescribe for vaginal should be Canesten 1 pessary. 



Treat the cause, not just the itch 

Registered tr.)dem.irk or Bayer AC Bayer and -f" are trademarks of Baver AG. 

Continued from p25 

patients know about the 
facilities available, the more 
they will use them. With 
increasing uptake comes 
increased efficiency. 

Protocols for Pharmacy 
medicines are now well 
known by us in the 
profession. How many 
patients know about them 
yet? How many pharmacies 
have thought to consult their 
community in the 
preparation stages? 

Similarly, surgery 
protocols for treating 
illnesses have merit. We 
know that most sore throats 
are viral and that it is a 
downright waste to use a 
broad spectrum antibiotic on 
a viral infection. How many 
patients know this? It makes 
sense to produce a primary 
healthcare treatment 
protocol for just this type of 

Let the patient know. 
Explain it. Give them the 
information about what you 
propose to do and involve 
them in the process. Identify 
the lead person in the team 
whose speciality it is and 
introduce the practitioner to 
the patient. 

At present, a pharmacy 
department within a heath 
centre is the exception 
rather than the rule. This is 
likely to change. The 
arguments in favour are 
legion, but let us not see the 
world through rose-coloured 
spectacles. Business is 
business. Some pharmacies 
have gone into health 
centres only to rue the day 
they ever gave up their own 
'shop' and became a tenant. 
This normally happens 
when the rent review is due. 

Looking on the positive 
side, whether the pharmacy 
is within the bricks and 
mortar of the health centre, 
adjacent to it or just down 
the road, there is a great 
deal it can bring to the 
primary healthcare team. 

The first and most obvious 
is the expertise in all 
medicines, Prescription 
Only Medicines, Pharmacy 
Medicines, and General 
Sales List. Next comes the 
actual dispensing process. 
This is, and will always be, a 
core function of the 
profession. To ensure that 
the patient receives exactly 
what the prescriber 
intended, in the correct 
form, with futl supporting 
information, promptly, 
safely and professionally is 
the essence of pharmacy. 

Remembering that everyone 
is a team player, how best 

can we in pharmacy use our 
skills for the benefit of the 
patients and the other health 
practitioners? It is rather like 
the situation where you give 
someone a blank piece of 
paper and ask for an essay 
without specifying the 

Fortunately for us, the 
answers have already been 
given to us in, among others, 
the 'Health of the Nation' 
targets. The document 

general health promotion. 
• Cancers 

Smoking is the biggest 
known cause of lung cancer. 
It is also linked to many 
other potentially fatal 
cancers. Smoking cessation 
advice and the supply of 
cessation aids, such as 
nicotine gum and patches — 
and the new spray — will 
therefore be a valuable 
addition to the team attack 
on preventable cancers. 

^Y@i i km f e « sign if 
w-^ team if you 


specifies five main areas of 
concern and lays down 
targets for improvement. 
The major areas are 
coronary heart disease 
(CHD) and stroke, cancers, 
mental health, AIDS plus 
sexual health, and, finally, 

Put the resource, you, and 
the information together and 
deliver the national or local 
health messages to the 
community where you work. 
In doing so, you are playing 
your part as an active and 
valuable member of the 
primary healthcare team. 
• CHD and stroke 
Factors which affect CHD 
and stroke include smoking, 
obesity, diet, cholesterol, 
alcohol, salt intake, blood 
pressure and exercise, to 
name but a few. Pharmacy 
staff are uniguely placed to 
give advice on smoking 
cessation, diets, cholesterol 
testing, safe drinking, blood 
pressure monitoring and 

team care plan. If you don't 
ask or offer, your strengths 
will go unnoticed and the 
patient lose out. 

Compliance is important. 
Drugs don't work in patients 
who don't take them. 
Counselling, advising on 
side-effects and general 
background knowledge are 
all invaluable. 

• Accidents 

Accidental poisoning by 
prescribed medicines still 
causes many unnecessary 
tragedies. Child-resistant 
tops on bottles are only a 
halfway house at best. 
Surely the answer to the 
problem is respect and safe 
storage of all medicines, 
keeping them away from the 
eyes and reach of children. 

DUMP campaigns attempt 
to remove all the unwanted 
and surplus medicines from 
our houses. A gentle 
reminder of the availability 
of your disposal service 
might one day save a life. 

Generat accidents still 
account for 9,000 deaths per 
year. The cause could be as 
diverse as drowsiness the 
morning after last night's 
steeping pill to light- 
headedness brought about 
by standing up too guickly 
while taking certain blood 
pressure treatments. 

The most common cause 
of death in people under 30 
is accidental. Your help, as 
part of an overall strategy, 
could save lives. 

• HIV and sexual health 
AIDS kills. Whether the 
source of the infection is 
shared infected needles and 
syringes or unprotected sex 
is immaterial. Prevention is 
our only defence, for the 
time being. Even if the 
victim does not contract 
HIV, there is the possibility 
of other sexually transmitted 
diseases, such as syphilis, 
gonorrhoea, non-specific 
urethritis, herpes and warts. 
The pill will prevent 
pregnancy, but is useiess 
against ail these contact 
diseases. Again, professionai 
advice is invaluable. 

Remember the sunscreens, 
too. So many peopte go 
abroad and disregard the 
risks of skin cancer. 
Melanomas can be terribiy 
disfiguring and are 
frequently fatal. Sensible 
advice from a healthcare 
team member could prevent 
all that heartache. 

Breast cancer and cervical 
cancer screening do not 
come within our remit, but 
advice on them does. 
• Mental illness 
This is the unseen and 
unspoken disease. It is still 
shunned by its victims and 
their families. Its effect can 
be devastating to patients 
and those close to them. 

With the closure of the 
large institutions, the former 
residents will be transferred 
to care in the community. 
Their care will be in our 
hands. Whether our role will 
be restricted to the 
immediacy of pharmacy 
alone all depends upon the 

OVER THE COUNTER 21 January 1995 


You have a significant part to 
play in the team, if you are 
prepared to become involved. 
The local surgery will be the 
focal point in most cases. The 
messages are already well 
documented for us all. The 
variable is how to communicate 
them to the people who will 
benefit most. Discuss with your 
pharmacist how your pharmacy 
may become involved as an 
active primary healthcare team 
member. Enjoy it, save lives and 
promote better health in your 


Put your best foot forward 

We keep them hidden most of the 
day, squeeze them into 
unsuitable shoes, we are often 
ashamed of them and generally 
take them for granted. However, 
we expect them to do all the 
running and support us in 
everything we do - feet quite 
simply get a raw deal! 

These very important parts of 
the body are a marvel of 
biological engineering. With all 
the stresses and strains feet are 
under, it 's no wonder that 
around 14 million people in 
Britain alone seek advice on 
common foot problems every 
year. The local pharmacy is often 
the first port of call for those 
afflicted by blisters, bunions and 
athlete's foot to name but a few. 

As a pharmacy assistant, your 
advice is invaluable. Therefore 
Mycil, the leading athletes foot 
treatment, is undertaking a 
survey to discover what your 
experiences are of the common 
foot complaints presented in the 

1. Do you feel you are equipped to 
handle questions from customers on 
foot care? 

All the time 
Most of the time 

Never - I always refer to the pharmacist 

2. How often do you give advice on 
foot care? 

Several times a day 

Once a day 

Several times a week 

Once a week 

Less than once a week 

3. From where have you obtained 
information on foot care? 

(please rate as follows: 1= most often; 5 = 
least often) 

From the Pharmacist 

From pharmacy assistant's or pharmacy 

From women's magazines 
From literature issued by manufacturers 
Formal training schemes - please state 


4. Please tick from the following list all 
those symptoms which indicate 
athlete's foot 

Itchy white and soggy skin often 
between the fourth and fifth toes 

Small splits in the skin often 
between toes 

Whole foot may appear red, itchy and 

Flaking skin 

Occasional weeping rash and distinct 


5. How would you rate the information 
you receive from manufactures on foot 

Please place a tick in the appropriate 
column against the criteria listed. 

I find it easy to 

It gives enough detail 
on foot care 

It helps me to answer 
the queries I receive 
from customers 

I often give out foot 
care literature to my 

I would find more 
Information on foot 
care useful 

I don't take any notice 
of manufacturer's 

6. What are the most common foot 
problems that people seek advice for 
in the pharmacy over the course of a 

Please rate as follows: 1= most common; 7 
least common 

Athlete's foot 

Corns and calluses/hard skin 

Sweaty/smelly feet 

Nail problems (ingrown toenails and nail 

Don't know 

7. Do you suffer from any foot 
ailments yourself? 


Please state 
What products 
do you use? 

8. If a customer has athlete's foot do 
they (generally speaking) seek your 
advice ? 

(please tick the most appropriate answer) 

They tend to self select the brands 
they want 

They tend to ask advice LJ 
Don't know 

9. What brands do you most often 
recommend to customers with foot 

Athlete's foot 

Corns and calluses/hard skin 

Smelly/sweaty feet 
Nail problems 

10. How do you decide what brands to 
recommend for foot problems? 

(please tick all those appropriate) 

Brands seen advertised 
Brands your pharmacist has told you 

Brands you have read about in pharmacy Q 

Brands you have read about in 

manufacturer's literature 
Brands you have always recommended 
Don't know 




If you spend hours on your feet all day, then 
you'll know that keeping feet healthy is top 
priority. Mycil have put together a "Healthy 
Feet Kit" to give your feet a break. It 
comprises a shoe bag (ideal for keeping 
trainers, work shoes or even your toiletries) 
and comes with: your own personal foot 
towel; wooden foot massager to relax and 
invigorate feet; a nail brush with a pumice to 
smooth hard skin; and one-size Totes Toasties 
to keep feet cosy. Mycil athlete's foot 
powder completes the pack. Combining an 
effective anti-fungal, tolnaftate, with an 
antiseptic, use Mycil to treat symptoms of 
athlete's foot, prevent reinfection and soothe 
the foot back to health. 

If you would like the chance to receive the 
Mycil Healthy Feet Kit, complete the coupon 
and send it with the questionnaire to Mycil 
Survey c/o Maureen Cropper PR, FREEPOST, 
London SW8 4YY by February 28th 1995. 

Mycil have produced a Step By Step Guide to 
Healthy Feet which offers customers advice on 
the problem ot athlete's foot. If you would like 
to receive free copies tick the quantity you 
require on the coupon. 



I would like the chance to receive one of 
20 Mycil Healthy feet bags. I am over 18 
years of age. 


Send me 10 J 20 J 30 J copies of 
Mycil's Step By Step Guide to Healthy 

Always read the label. 


Mycil Survey 

c /o Maureen Cropper PR 


London SW8 4YY 

Health and safely 

at work 

Health and safety at work 
can tend to be one of those 
things which we do not think 
about until something goes 
wrong. And things do go 

According to a Health and 
Safety Executive Report 
(early 1994), the overall cost 
of work-related ill health 
and accidents, including 
those where no one gets 
hurt, is between £11 
billion and £16bn per 
year. This vast sum of 
money is egual to 
between 2 and 3 per cent 
of the gross domestic- 
product (GDP). 

To take the figure 
further, the cost to 
employers is between 
£4bn and £9bn per year, 
equating to between 
£170-£360 per person 
employed. The 
remainder of the total 
loss is the cost to 
individual workers and 
their families, social 
security payments and 

Looking at these 
figures it quickly 
becomes clear that it 
makes sense, both in 
terms of preventing 
injury and in preventing 
another drain on the 
profits of your pharmacy, 
to avoid accidents and 
health hazards. 

The sad thing about 
the huge amounts quoted 
above is that many of the 
accidents and much of 
the ill health resulting 
from problems at work 
could be prevented by 
more care on the part of 
everyone employed and 
better management of 
the work environment. 


There has been 
legislation concerned 
with safety at work for 
;many years in Britain. The 
main piece, The Health and 
[Safety at Work Act, was 
Ipassed in 1974. Since then 
there have been many 
changes and additions to the 
Act. The most recent 
changes, known as the 'six 
(pack', have come about 
because of European 
requirements and are 
concerned with managing 
health and safety, and 
assessing risks. 
Everyone at work has a 

As an employee you are entitled to 
healthy and safe working conditions. 

Training consultant Diane Bailey 
explains the laws that protect workers 
and practical ways of reducing risks in 
the pharmacy 


legal duty to: 

• work safely 

• take reasonable care for 
the health and safety of their 
colleagues and customers 

• keep the workplace safe 

• work with their employers 
to ensure that the business is 
run within the requirements 
of any legislation. 

Under the relevant 
legislation your pharmacy is 
responsible for providing 
healthy and safe working 
conditions and for ensuring 

that all work operations are 
carried out safely. 

Who's responsible? 

The senior manager, or 
board director in a larger 
pharmacy organisation, is 
responsible for ensuring that 
safe working practices have 
been defined and are in 
place. All managers are 
responsible for 
implementing these safe 
working practices. 
Supervisors are 

OVER THE COUNTER 21 January 1995 

responsible for maintaining 
safe working conditions and 
for training other staff in the 
correct and safe way of 
working and using any 
eguipment. All employees 
are responsible for using the 
safe working methods 
defined and for the safety of 
visitors and customers. So, as 
you can see, the 
legislation gives 
everyone in your 
pharmacy specific 
responsibilities for 
health and safety. 

To ensure that 
pharmacies and other 
companies comply with 
legal requirements on 
health and safety there 
are two main enforcing 

the Health and Safety 
Executive and the local 
council's environmental 
inspectors. Failure to 
meet the reguirements 
of the legislation can 
result in a fine or 
imprisonment or both. 

Risks and hazards 

What are the risks or 
hazards to health and 
safety in a pharmacy? 
You will already be 
aware of the strong 
requirements for storing 
and dispensing drugs 
and medicines. Your 
pharmacist may already 
keep detailed records of 
customers who have 
had prescriptions filled, 
so that they can advise 
on likely reactions when 
new drugs or medicines 
are prescribed. 

In addition to 
prescription medicines 
and drugs, there are 
many other things in 
your pharmacy which 
could be hazardous to 

COSHH stands for 
'control of substances 
hazardous to health'. This is 
an important set of 
regulations designed to 
protect you, your colleagues 
and customers from 
hazardous substances. Any 
company which uses such a 
substance has to: 

• identify and control it 

• minimise risks from 
exposure to it 

• provide all the information 
and training required. 

Continued on p34 



New year skin care 

Win a day at a top London health club! 

Christmas in the 
pharmacy is one of the 
busiest times of the 
year and it is one time 
when the pharmacy 
assistant, as health and 
beauty advisor, is called 
upon to suggest 
toiletries and presents 
and recommend 
remedies for the 
festive break. However, 
January and February 
are also a busy time for 
the pharmacy team as 
the cold, dark months 
bring a host of 
common ailments. 

For the 12 million or more 
people in the UK who suffer 
from cold sores this can be a 
particulary distressing time 
of year. Colds and flu are 
more prominent in the 
winter months and, along 
with feeling tired after the 
party season, can often be 
"trigger" factors for cold 
sores. Caused by the Herpes 
Simplex virus, cold sores can 
be easily spread by kissing - 
something your customers 
will be very aware of after 
the recent round of 

January is one of the most 
stressful months, with 
people generally feeling low 
after Christmas and the 
strain of returning to work. 
The result is that people get 
run down more easily and 
are more susceptible to 
illness. Along with the 
requests for cold remedies, 
tonics and vitamins, remind 
your customers to keep 
some useful items , such as 
Zovirax* Cold Sore Cream, 

to hand so that they can 
treat minor problems in the 
early stages. Remind them if 
they suffer from cold sores, 
using Zovirax* Cold Sore 
Cream at the tingle stage 
can prevent the cold sore 
from appearing, and if the 
cold sore is developed can 
speed up the healing 

< oldsoir do's and 

DO Always wash your 
hands after touching cold 
sores, or applying 
medication to them, as they 
are highly infectious 
DO Avoid touching your 
eyes. Women should be 
especially careful when 
applying make-up 

DO Avoid kissing, 
especially children, when 
you have had a cold sore 

Use saliva to wet 
contact lenses 

Break the blisters 
or pick the scabs. Not only 
can you infect your fingers 
with the virus but you may 
infect your cold sore with 
other bacteria 

Share your 
eating and drinking utensils 

Share your towel 
with others. 

To help with general tips 
to keep skin and hair in 
good condition, a nutritious 
diet, exercise and plenty of 
sleep are key ingredients to 
feeling and looking your 
best for New Year. Your 
customers may find the 

Cold sore triggers 
Colds and flu 

• Feeling run down 


• Menstruation 

Emotional upset 

• Bright sunlight 

Stomach upset 

• Fatigue 

Physical injury 

following hints useful as 
part of a New Year's health 

Hot lip lips 

L - Remember that the 
skin on the lips is very 
sensitive and needs special 

I - Invest in some beauty 
sleep to prevent dull and 

lefence with Zovirax 


tired looking skin 

P - Protect your lips with 

moisturiser and balm to 

prevent chapping and 


C- Carry Zovirax* Cold 
Sore Cream with you at all 
times to treat the cold sore 
before it develops 
A - Fresh a/rand exercise 
oxygenates the tissues and 
keeps the skin looking 

R - Remember that stress 
affects your looks and can 
cause cold sores, so try to 
keep calm 

E - Eat fresh fruit and 
vegetables to stop you 
getting run down and to 
give your skin the nutrition 
it needs. 

However, if a customer is 
unfortunate enough to 
suffer from a cold sore just 
before an important event, 
particularly with Valentine's 
Day coming up, suggest 
they try out the following: 
>• Apply some stick 
concealer direct to the cold 
sore and blend in well. 
i- Apply a thin layer of 
foundation over the top and 
set with powder. 
>• Women could then 
apply the usual shade of lip 
colour - a different shade 
will only draw attention to 
the lips. 

The Competition 

Pampering Prizes - win a 
luxury prize and indulge 
yourself after the 
Christmas rush! 

The first prize winner will 
receive a voucher for a day's 
visit to The Sanctuary, an 
exclusive, all female health 
and beauty club in London's 
Covent Garden. The 
Sanctuary has a beautiful 
pool, and the lucky prize 

winner can choose from 
treats such as facials, herbal 
body wraps and 
aromatherapy massages. 

Men can work out for a 
day at a top London health 
club of their choice, with 
vouchers for sauna, jacuzzi 
and massage facilities. 

The runner-up prize, for 
the ladies, will be a make- 
over from a top make-up 
artist or a make-up lesson at 
a local health and beauty 
salon. The men can indulge 
in a haircut, professional 
shave, manicure and 

Third prize will be a 
voucher for a beauty treat: a 
manicure or pedicure for the 
ladies, or a designer 
grooming kit for the men. 
The voucher will be 
redeemable for up to three 


How to enter: 

I Answer the following five questions to win one of these luxury prizes 
I What is the virus ealled which causes cold sores to develop? 


_ 2. Name tour ol the common "trigger factors tor cold sores. 

3. How many people in the UK (on average) suffer from cold sores'" 

4. Can the virus infect other parts of the body? 

5. Complete this sentence - "Treating the tingle. 

Complete your entry and send it to: OTC/Zovirav Competition. 
I Chemist & Druggist, Benn Publications Ltd. Sovereign Way, 
■ Tonbridge. Kent TN9 1R\V. 





0\ I RAX 


Early use can stop 3 cold - 



For more information about Zovirax* Cold Sore Cream please write to 
the Cold Sore Information Centre, 37 Soho Square, London W1V 5DG. 
"Trademark. Always read the label (contains aciclovir). 

The rules 

/. Tlu\ competition is open to L k pharmacy assistants only 2. li is not open to employees of Warner-Wellcome their families or agents 3 All entries become 
the property of Warner-Wellcome. 4. Only one entry per person is allowed 5. The closing date is February 15, 1995. n. Entries received after this date will 
no! be acceptable. 7 ,\;, alternatives, cash or otheru ise n ;// be given as prizes 8 The editor's decision is final and no correspondence can be entered into. 

C®M»inueeS from p3 1 

The types of health hazard 
could include: 

• poisoning 

• skin burns and irritation 

• eye burns and irritation 

• asphyxiation. 

Talk to your pharmacist 
about substances and 
materials which are used or 
available and which need 
extra care in handling, 
storage or ventilation. 

When dealing with 
customers, remember that 
they will want information 
on materials and medicines, 
how to use them, which 
things are hypo-allergenic, 
health effects, etc. 

Other black spots 

Where else can safety be 
threatened in your 
pharmacy? The answer to 
this is just about anywhere 

— in the office, on the shop 
floor, in the kitchen. 
Filing cabinets 

The load should be spread 
evenly between all drawers. 
If the cabinet is only filled at 
the top, it can tip over when 
the top drawers are opened. 
Keep drawers closed when 
not in use: falling over a 
left-open lower drawer can 
cause a bad injury. Don't 
store heavy items on top of 
cupboards or filing cabinets. 

Make sure that electric 
cables are not frayed and 
that plugs have the correct 
fuse, and that they are not 
broken. Ideally you should 
remove plugs from wall 
sockets at the end of every 
day. Hundreds of accidents 
are caused by people 
tripping over telephone and 
electrical leads. 

Many accidents in retailing 
are caused by people falling. 
Falls can be caused by worn 
carpets, damaged lino, 
blocked walkways and 
aisles, dark or obstructed 
stairways, creams and 
lotions spilt on floors, wet 
floors, badly-stacked goods 

— the list is endless. 
Walk around your 

pharmacy, try to see it with 
new eyes, don't just take 
things for granted. Are there 
any problems which could 
cause falls or trips? 
The shop floor 
It would be ironic if a 
customer had an accident in 
a pharmacy, a place 
dedicated to maintaining 
and improving peoples' 
health. Many hazards lurk in 
the shop. Glass bottles can 
fall and break, heavy goods 
can be insecurely placed on 
shelves or fixtures, rough or 
broken fixtures can scratch 
hands or legs or catch in 
clothing, poorly balanced 
displays can be knocked 

over. You and your 
colleagues should take it in 
turn to walk the shop and 
check that everything is safe 
and secure. 

:.: -rr 

The old saying is that fire is 
a wonderful servant but a 
fearful master. Know where 
the fire-fighting eguipment 
is in your pharmacy, and the 
emergency exits. Ask the 
pharmacist what procedures 
are to be followed in case of 

Remember that you have 
a responsibility for the safety 
of customers and colleagues 
as well as yourself. 

The Loss Prevention 
Council gives the following 
statistics for the causes of 
fire. A huge 49 per cent is 
caused by arson, but of the 
other 51 per cent many 
could be prevented by 
regular and careful hazard 
spotting and by simple rules 
for such things as smoking 
and the use of electrical 

Accident reports 

No matter how careful you 
are in your pharmacy there 
can always be the occasional 
accident. You need to know 
exactly what to do if one 

Your pharmacy has a duty 
to keep proper records of 
any accidents and to notify 
the authorities of any major 
accident or dangerous 

Minor injuries, such as 
cuts and bruises, must be 
treated and noted. Major 

accidents include broken 
bones, loss of a hand or foot, 
or part of a finger or toe, or 
anything which keeps an 
individual in hospital for 
more than 24 hours. 

If you do not already 
know, find out where the 

needs to be done to prevent 
it happening again. 

Staying safe 

If you want to meet your 
legal responsibility for health 
and safety and to play your 
part in keeping your 

Causes of fire 

Other mechanical Causes uncertain 

Blow lamps 


pharmacy accident book is 
kept and how major 
accidents should be 

You should also watch out 
for dangerous incidents. This 
is when something goes 
wrong, but luckily nobody is 
hurt — things might not turn 
out so well next time. 

If a dangerous incident 
occurs, treat it in the same 
way as you would an 
accident. Try to work out 
how it happened and what 

pharmacy free from hazards, 
keep your eyes and ears 
open. If you see a potential 
problem, do something 
about it or ask your 
pharmacist to do so. Don't 
forget to check that action 
has been taken. 

Remember that staying 
safe and healthy at work is 
very much a matter of 
knowing what can go wrong! 
and working with your 
colleagues to prevent it from! I 
doing so. 

Hazard spotting 

Good housekeeping and tidiness are essential parts of having a healthy and safe 
workplace. A tidy workplace is usually a safe one. You can help to make your pharmacy a 
safe place to work and to shop. 

Every year, 50,000 people are seriously injured at work by falling over, stepping on or 
striking against objects. Good housekeeping could prevent many of these. Work out a rota 
with your colleagues so that every week one of you spends a few minutes checking for 
hazards. You know your premises best, so why not work out a hazard-spotting checklist 
which you can all use? The sorts of hazards you could keep an eye out for include: 

• Electricity 

Traihng flexes, overloaded power points, frayed wiring, plugs which feel warm in use, 
plugs or electrical items which spark, electrical eguipment too close to water. Is your 
lighting good enough for safe working and safe movement from pface to place? 

• Floors and stairs 

Are all floors and stairs clean and free from litter? Is carpet or floor/stair covering properly 
secured and free of holes or very worn patches? Are floors free of spiilage, oil grease, 
cream, etc? 

• Fixtures and aisles 

Are fixtures properly filled, eg heavy items at the bottom? Are fixtures free of spfinters, 
cracks and broken surfaces? Are aisles kept free? 

• Fire 

Is smoking restricted to identified areas? Are cigarette ends put in ashtrays and not into 
wastepaper bins? Are electric fires and temporary heaters turned off at night or when not 
is use? Are there sensible rules for the use of electrical eguipment? Is the fire exit kept 
clear and unblocked? 

• Merchandise 

Are aU glass bottles carefully positioned on shelves and fixtures? Is glue and solvent-based, 
material separately stored? Do all staff know the health hazards relevant to different 
merchandise groups? Are customers always given clear and complete instructions about 
how and when to take medicines or use the counter products? 

OVER THE COUNTER 21 January 19! 


UUMrt 1 1 1 IUN 

The right time for a tonic 

Willi Winter comes the prospect of customers w ho are feeling 
generally run down and lethargic, looking for something to perk 
them up. If these feelings can be attributed to a recent cold or 
bout of 'flu, one the of the best recommendations is a tonic. 

Questions to ask 

® Has the customer recentlj had a cold or bout of 'flu? 

@ Has the customer lost his/her appetite'.' 

S Does the customer feel tired and generally run down? 

Why recommend a tonic? 

© Because common colds and 'flu which attack the body's defence 
system leave us susceptible to further infection, so the body can 
benefit from a tome. 

A tonic winch contains a careful balance of the right vitamins 
and minerals without the use of artificial stimulants is the most 
natural type. 

Seven Seas Vitamin and Mineral Ionic is a licensed product for 
restoring vitality when tired or run dow n and contains both 
vitamins and minerals which are essential for the normal 
functioning of our bodies. They are necessary for our vitality and 
general well-being, making them the most important and natural 
vvav to remove lethargy. 

Vitamin types 

J ! Vitamin A is one of the most important vitamins for helping to 
repair the skin and all the surface tissues, including the mucus 
membranes. Foods which are rich in vitamin A include fish liver 
oils, liver, carrots, green and yellow vegetables, eggs. milk, dairy 
products and margarine. 

I' Vitamin 1) is another important vitamin for the body's recovery 
process. Like vitamin A. it is a fat soluble \itamm and is \ital for 
the absorption of vitamin A. Ciood sources include fish h\er oils, 
oily fish such as sardines, tuna and herrings, milk and dairy 

C ! Iron is one of the most important sources of energy in our both 
-it helps in the production of haemoglobin, which carries oxygen 
around the body, preventing iron-deficiency anaemia. It plays an 
important role therefore in preventing fatigue and can help restore 
appetites following illness. Foods rich in iron include offal such as 
liver and kidney, red meal, egg yolk, nuts, beans, oatmeal and 
green vegetables such as spinach and asparagus. 
• Calcium glycerophosphate and potassium glycerophosphate are 

The rules 

/ lhi\ competition is open to UK pharmacy assistants only. 2 It i\ not open 
property of Seven Seas. 4. Only one entry per person is allowed 5. The closin, 
acceptable. 7. No alternatives, cash or otherwise will he given as prizes. .V. 77;. 

recognised .is important appetite restorers and are used in Seven 
Seas Tonic in conjunction with iron to help restore appetites and 
get the bod} on the road to recovery. 

All these \ itamins and minerals are contained in Seven Seas 
Vitamin and Mineral Ionic and the pleasant tasting natural 
orange flavoured liquid can be taken cither on its own - one 1 0ml 
dose three times daily - or in diluted form 

There are now three si/es ol the Vitamin and Mineral Ionic 
available: 5(>(>ml (14.2 1 )). 300ml (£3.19) and a new trial size I 50ml 

The compel il ion 

Twelve OTC readers can win Marks & Spencer gift vouchers by 
answering the following questions. The lust correct entry will win 
£250 worth of vouchers; the next correct one 1100 and the 
follow i ng ten coi reel entries will each receive £10 worth of 


I Which two vitamins are contained in Seven Seas Ionic'.' 

2. Seven Seas Tonic contains no artificial stimulants 
true or false'.' 

3. Name the symptom of iron deficiency 

4. Name two foods rich in both vitamin A and D 

5. What is the recommended daily dosage of Seven Seas Tonic'. 

6. What si/es of Seven Seas Ionic are available 

Send your entry to OTC/Seven Seas Tonic Competition. Chemist 
& Druggist. Benn Publications Ltd. Sovereign Way. Tonbridge. 
Kent JW IRW. Closing date is February 15. 1995. 





to employees of Seven Seas, their families or agents 3 All entries become tin 
date is February 15, 1995. 6. Entries received alter this date will not be 
editor's decision is final and no < orrespondence can be entered into. 

Take the heat 
out of colds 

It's that time of year again — when all your colleagues are off 
with the self -same cold that's afflicting your customers. 
Marianne Mac Donald looks at how you can fight back 

Imagine sweltering in the 
heat of your very own 
paradise isle. A host of 
servants cater to your every 
whim, no matter how 
outrageous. And, best of all, 
it's all paid tor by other 
people's colds! 

Ah yes, the elusive cure 
for the common cold. Almost 
everyone has their own 
'cure' that they swear does 
the trick. If only they could 
get it onto the market! Well, 
it's a financial bonanza that 
makes the lottery look as 
appealing as used tissues. 

So, why is it, with so many 
colds and so many 'cures', 
that we still find ourselves 
trying to keep the snuffles at 

The answer is that colds can 
be caused by one of over 
200 different viruses, the 
most notorious being the 
rhmovirus family. So, if you 
sutler the average two colds 
per year, then, in theory, you 
would need to live to be over 
f 00 to build up immunity to 
all ol them. 

However, nature isn't that 
simple; immunity after a cold 
is short, so you'll never be 
fully protected. If it's any 
consolation, re-infection 
from a virus you've had 
before does produce a much 
milder cold. 

With so many different 
viruses responsible, it's easy 
to see why vaccine 
development is impossible. 
Even though there's only 
three flu viruses, each year 
the flu vacccine has to be 
re-formulated to take into 
account the different strains 
in the atmosphere. Now 
imagine the problem of 
juggling umpteen strains of 
200 cold viruses! 

Another cold mystery is 
why some people seem to 
suffer more than others. Age 
is a major factor. According 
to Dr Ron Eccles, director of 
the Common Cold and Nasal 
Research Centre in Cardiff, 
young people suffer 
between three to five colds 
per year (and children can 
suffer as many as eight) 
because they have less 
immunity. By the time we 

reach fate middle age this 
drops to two. 

We can't fight against our 
age, however hard we try, 
but we can fight the cold 
war in other ways. 

The old adage "feed a 
cold and starve a fever" has 
some truth in it: a poor diet 
can make you more 
susceptible to catching the 
cold, and more inclined to 
suffer worse symptoms. 
Likewise, if you're feeling a 
bit under the weather or 
coping with a lot of stress — 
the pamper factor should 
never be underestimated! 
Smokers are also prone to 
suffer more. 

Less controllable factors 
which can make your cold 
more miserable include 
other medical conditions. 

If you're an adult you're 
more likely to catch a cold in 
the winter months, while 
children, with their 
developing immune systems, 
tend to suffer all year round. 
One noticeable peak is 
when children return to 

screening of ra volunteer by the medical officer at the Common Cold and Masai 

\ Colds through the 


Neanderthal man may have 
worried about how to catch 
his next meal, but he never 
had to worry about catching a 
cold. Our predecessor didn't 
suffer colds, and no, it wasn't 
because he was considerably 
hairier than his modern 

Neanderthal man was 
spared because the world's 
population was smaller and 
he lived in a rural 
environment. When man 
became a city boy, around 
5,000 years ago, the cold 
virus was born. 

Iraq may seem like an 
unlikely birthplace for the 
common cold, but it was the 
first civilisation to have cities 
of around 300,000 people — 
enough of a population to 
ensure the virus thrived. 

school after the summer 
break. And, almost 
inevitably, they come home 
to give it generously to mum 
and dad! 

If you do catch your 
annual cold, then you'tl 
know all the symptoms: 

• a sore throat about eight to 
ten hours after infection 

• a well-developed cold 
after 24 hours with a 
blocked runny nose. This is 
caused by swelling of the 
nose lining which then 
produces excess mucus 

• headache if the sinuses are 
also congested 

• possibly a cough. 
People are usually 

infectious for up to 24 hours 
before symptoms really 
begin and for around five 
days after. But sometimes 
you can have colds without 
the futl-blown symptoms. 

Back to Dr Eccles: "Saying 
you get three to four colds a 
year is just a symptomatic 
common cold; you may get 
six or seven." Remember 
that sore throat you put 
down to air conditioning? It 
may have been a cold. 

It doesn't matter what you 
do, or what you take, a cold 
will last for around seven 
days. So why bother taking 
anything at all? 

A lot of people don't, 
preferring to wrap up warm 
and eat and drink plenty. 
For those that need extra 
help, there is an array of 
products geared at offering 
symptom relief, making life 
a a lot easier to cope with. 
1 Boning up on the various 
| ingredients in the many cold 
J remedies available over the 

Continued on p38 ► 




For the first time ever, ibuprofen and 
pseudoephednne come together in a unique 
formulation to give outstanding efficacy. 

New Nurofen Cold & Flu has been shown to 
outperform a paracetamol-based combination 
in the relief of major cold and flu symptoms': 


The proven decongestant, pseudoephednne, 
in Nurofen Cold c\ Flu makes it effective in 
relieving these symptoms 1 . 

Sinusitis . 

Ibuprofen's analgesic and anti-inflammatory 
action, accompanied by pseudoephedrine's 
proven decongestant efficacy makes 
Nurofen Cold & Flu more effective, after 
3 hours, than a paracetamol / phenyl- 
propanolamine combination'. 

Fever . 

Ibuprofen provides greater and longer-lasting 
relief of fever than paracetamol. 1 

Sore throats . 

Since these are often associated with inflammation. 

ibuprofen's superior anti-inflammator) 
properties make it more effective than 
paracetamol in the relief of sore throats. 

Headaches and other aches and pains . 

Ibuprofen has been shown to be more effective 
than paracetamol in the relief of headaches' 
and other aches and pains. 

When your customers are suffering from 
colds or flu, you now need only one 
recommendation: Nurofen Cold c\ Flu. 


■e copy nf our comprehensive clinical guide, please contact: Crookes Healthcare Ltd. P.O. Box S7, Nottingham NG" 2L| PRODUCT INFORMATION- Nurofen Cold & Flu: each tablet c. mtains 200mg ibuprofen BP and 30mg pseudoephednne 
wide BP. Indications. Symptomatic relief of cold and flu Dosage and Administration. Adults and children over 12 years: Initial dose 2 tablets, then if necessary 1 or 2 rablets even 4 hours Do not exceed 6 tablets in an> 24 hour period. 
3ns and Warnings. Nurofen Cold is; Flu should not be given to patients with peptic ulceration or with serious cardiovascular disease. Patients receiving regular medication, asthmatics, anyone allergic to aspirin, pregnant 
ist feeding women should he advised to consult their G.P, before taking Nurofen Cold & Flu. Not to be given to children under 12 years. Adverse effects reported include: dyspepsia, gastrointestinal intolerance and , , , _ 
es. Product Licence Number. PL/0327/0060. Licence Holder. Crookes Healthcare Limited, Nottingham. NG2 3AA. Legal Category. P. Price. Nurofen Cold & Flu Tablets 12's £2 : u . Nur Tablets 24's £3.4 &m? a 7!\ 

NCES: 1. Data on file, Crookes Healthcare, 1990. 2. Walson PD. et al, Clin, Pharmacol. Then. 1989;4b: 9. J. Schachtel, B.P. Clin. Pharmacol. Ther.. 1988. 44, 704. 4. Novclle. R.M. et al. Pharm J. 198". 23s. 561. 

Continued from p36 

counter will pay dividends 
both for the customer and 
the pharmacy. 

Did you know that more 
than 65 per cent of cold 
sufferers come into the 
pharmacy for advice, with 90 
per cent of these acting on 
the pharmacist's 
recommendation? And 
your's is the first friendly 
face they see through their 
red-rimmed, watering eyes! 

• Decongestants 

These are the mainstay of 
treatment as the blocked-up 
f eeling of nasal congestion 
with the accompanying, and 
not very attractive, runny 
nose have been identified as 
the most bothersome aspects 
of a cold. Decongestants are 
divided into four types: rub, 
inhalant, oral and topical. 

• Inhalants, such as Karvol, 
Olbas Oil and Tixylix 
Inhalant, are very popular 
for use in children. Parents 
perceive this as a very safe 
method, and it bypasses 
children's suspicions of the 
medicine spoon! 

Inhalants contain a 
mixture of volatile oils, such 
as menthol, eucalyptus, 
camphor and wintergreen, 
and are used by dropping 
liquid onto a handkerchief or 
pillow, or using as a steam 


Advise customers never to 
put them directly onto skin 
as burns can occur with 
prolonged contact. And 
remember they cannot be 
used in children under three 
months of age. 
• Chest rubs, like Vicks 

Vaporub and Mentholatum 
Balm, incorporate volatile 
oils in an ointment base for 
applying directly onto the 
skin or for use as a steam 
inhalant. Again they cannot 
be used in children under 
three months, or six months 
in the case of Vicks 



An Introduction To Homoeopathy 

a are delighted 
to announce a free 
training seminar 
specially tailored to the 
needs of the pharmacy 
assistant. For dates and 
further details, please 
call Sandra Mount on 
01159 309319 







Anthroposophic & Homoeopathic Medicines & Natural Bodycare Products 
Weleda (UK) Ltd, Heanor Road, Ilkeston, Derbyshire DE7 SDR 


• Topical decongestants use 
sympathomimetics which 
mimic the effects of that part 
of the nervous system which 
causes narrowing of the 
blood vessels. Topical 
decongestants are applied 
direct to the fining of the 
nose, reducing blood flow 
and consequently 
inflammation and mucus 
production, making 
breathing easier. 

Ephedrine nose drops 0.5 
per cent are said to be the 
mildest. For a stronger effect 
recommend xylometazoline 
(eg Otrivine, Vicks Sinex), 
phenylephrine (eg Fenox) or 
oxymetazoline (eg Afrazine). 

While topical 
sympathomimetics are very 
effective, they do cause 
rebound congestion. In 
short, the products 

themselves appear to cause 
congestion with prolonged 
use. Advise customers not to 
use them for longer than one 
week. Fortunately, that's the 
normal duration of a cold. 

• Oral sympathomimetics 
also narrow blood vessels — 
both in the nose and 
elsewhere in the body. This 
can cause problems as they 
may increase blood pressure 
and heart rate. 

Because of this, they 
should be avoided in 
patients who suffer from 
high blood pressure or heart 
disease. They also interact 
with a range of medicines so 
patients should be referred 
to the pharmacist. 

Although oral 
sympathomimetics do not 
cause rebound congestion 
they do have other side 
effects. These include 
headache, anxiety, 
giddiness, sleeplessness and 
dry mouth. 

The most commonly used 
oral decongestants are 
phenylephrine, ephedrine 
and phenylpropanolamine. 

• Antihistamines are often 
used in cold remedies as 
histamine is one of the 
products produced when 
inflammation occurs. Using 
an antihistamine reduces 
nasal inflammation and so 
helps dry up congestion. 
Generally they are 
combined with 
sympathomimetics to give a 
dual action. 

Most of these products use 
the older antihistamines 
which tend to cause 
drowsiness, such as 
diphenhydramine (in 
Benylin Four Flu), 
chlorpheniramine (Contac 
400), promethazine (Night 
Nurse) and triprolidine 

As most patients buy cold 
remedies in an attempt to 
'keep going' it's best to 
check whether they really 
want something that might 
make them doze off in the 
middle of the day! 

Again, take care that the 
patient is not on any other 

Continued on p40 P 

I Refer to pharmacist 

Refer to the pharmacist if patient has: 

• discharge from ears 
: • painful cough 

• failure to get better in one week (may not be a cold, it 
: may be hayf ever or atopic rhinitis) 

• mucus becomes green or yellow or condition worsens — 
patient may have a bacteriaf infection requiring antibiotics 

• children less than three months with difficulty in 

• children less than six months who are feeding poorly or 
have weight loss 

OVER THE COUNTER 21 January 199: 

ite simply wherever your customers go this winter Olbas goes too. 

>ur biggest ever £300,000 
:vision campaign in the Granada, 
•der, Yorkshire and Tyne Tees 
as, backed by another £400,000 
lational press throughout the UK, 
s a point of sale package will bring 
| sales rattling through your till, 
^ere'll be no getting away from 
| power of Olbas this winter. 

So get stocked up through 
Dendron (Tel: 01923 229251) or 
your local wholesaler. 


the POWER to SELL 


Registered trademark and product licence held by G R Lane Health Products Lid . Sisson Road, Gloucester GL1 30B Active Ingredients: Cajuput Oil BPC • 18 50% w/w. Clove Oil BP - 10 w/w. Eucalyptus Oil BP ■ 35 45%, Juniper Berry Oil BPC 49 - 2 70% w/w. Menthol BP - 4 10 w/w, 
sed Mint Oil BP - 35 45% w/w. Winlergreen Oil BPC 49 3 70% w/w Directions: 1 By application to the skin Apply lightly to the painful area 3 limes daily By inhalation 2 Adulls and children over 2 years old Sprinkle 2 or 3 drops on a handkerchiel or add to hoi water and inhale the vapours 
months to 2 yeats one drop on a tissue placed out ol the child's reach Indications: 1 By application to the skin Symptomatic relief ol muscular pain and stillness including backache, sciatica, lumbago, Irbrosilis and rheumatic pain 2 By inhalation For Ihe relief ol bronchial and nasal 
caused by colds, catarrh, inlluenza and haylevei, rhinitis and mtnoi inleclion ol Ihe respiratory tract Route ol administration By inhalation and perculaneouslv Precautions: For inhalation or external use on unbroken skin only Not tor use m babies under 3 months old Keep all medicine out ol 

Iten. Do not use it sensitive to any ol Ihe ingredients. Legal Category: G Packs: Bottles ol 10ml and 28ml (PL 1074/5029R) Price: I 

ITILLES Registered trademark and ptoduct licence held by G R Lane Health Products Ltd . Sisson Road. Gloucester GL1 306 Active ingredients: (%wAv) Peppermint Oil BP 1 12%, Eucalyptus Oil BP 1 16%, Juniper Berry Oil BPC 1949 067%, Winlergreen Oil BPC 1949 047%, Clove 
25,4; Menthol BP 0.10%, Directions: Dissolve one pastille slowly in Ihe moulh when required Indications: For Ihe symptomatic relief ol colds, coughs, catarrh, sore throats and tlu, catarrhal headache Precautions: • ,- • 

ul ol Ihe reach ol children No more than 8 pastilles should be laken in any 24 hour period Not suitable lor children under 7 years Do not use il sensitive to any ot Ihe ingredients Legal Category: Senetal Sales List Packs: 45g (PL/1 074/0001) Price: RSP £1 45 

Continued from p38 

medication as antihistamines 
do interact with a number of 
drugs, in particular those 
which cause drowsiness. 
Analgesics relieve the pain 
of sinusitis and headache 
and bring down fever, 
although this symptom is 
more common among flu 

The best analgesic to 
recommend depends on the 
person, and type of pain it is 
intended for: 

• aspirin is good for aching, 
muscle pain as well as 
reducing fever. It cannot be 
used in children under 12 
because of the risk of 
contracting Reye's 
syndrome, and in asthmatics, 
people with stomach 
problems or those who are 
allergic to aspirin 

• the non-steroidal 
anti-inflammatory drug, 
ibuprofen, acts in a similar 
manner to aspirin, although 
it is claimed to be faster 
acting. Again, it cannot be 
used in asthmatics or those 
with stomach problems. It 
should also be avoided in 
people who are allergic to 
aspirin as there is a risk that 
a similar reaction may occur 
with ibuprofen use. 

Unlike aspirin, it can be 
used in children under 12, 
tollowing the introduction of 
an ibuprofen syrup (Junifen) 
last year. 

• paracetamol does not 
reduce pain associated with 
inflammation, but it does 
combat fever. The hidden 
danger is one of overdose 
where paracetamol builds 
up in the liver causing 
damage and occasionally 
leading to death. 

To avoid this, always 
make sure the customer 
knows the importance of 
taking the correct dose. 

Multiple attack 

With such a variety of 
different symptoms, it's easy 
to see why taking a pill for 
every cold ill makes 
customers feel like a 
walking medicine cabinet. 
That's why manufacturers 
are turning their attentions 
to magic bullets: one 
spoonful or tablet deflects 
the worst a cold can throw at 
you. Usually these products 
combine a decongestant, an 
analgesic and possibly an 

For convenience, they're 
wonderful, but they're not 
without problems. There's 
the danger that customers 
may buy more than one cold 
product, all containing 
similar ingredients, to use at 
the same time. Why stick to 
one magic bullet when two 
would do even better, they 

-fr j ffl . fl SjaLjc: 

Is there any truth in old 
wives' cold remedies? Dr 
Ron Eccles, director of the 
Common Cold and Nasal 
Research Centre, lays some 
myths to rest. 
Hot drinks: "A hot drink 
without any medication will 
promote salivary secretion 
and provide relief, but only 
for about half an hour," 
says Dr Eccles. 

Salivary secretion is 
controlled by the same area 
of the brain that operates 
the respiratory tract. 
Encouraging salivation 
switches on secretion in the 
respiratory tract, soothing 

Dr Eccles suspects that 
manufacturers use this in 

I their coldcare drinks as 
they will soothe the 
inflamed throat. Flavour 

i also has an effect as the 
more savoury a drink, the 
more stimulating, and 
hence more effective. But 
hold your breath for his top 
tip: "A peppery-type drink 
would promote a lot of 

Hot toddies: If hot drinks 
are a good idea, then hot 
toddies are an even better 

"Hot toddies will make 
lyou more congested, but 
only when you lie down, 
not when you're sitting." In 
other words: avoid alcohol 
before going to bed as it 

could make congestion even 

Vitamin C: "The latest 
review indicates that vitamin 
C does not prevent you 
getting a cold. What it does 
do is ameliorate the 
symptoms — but only when 
above a dose of 1.2g per 

At this dose, vitamin C 
acts not as a simple vitamin, 
but as an anti-oxidant, 
mopping up free radicals. 
These radicals are produced 
by white blood cells 
following cold-induced nasal 

Zinc gluconate lozenges: 

"Trial results are both for 
and against. But I wouldn't 
rule it out as being 
effective." The main 
problem with these 
lozenges is they don't come 
into direct contact with the 
infected area in the nose. 
But Dr Eccles suspects they 
may have an indirect effect 
by promoting salivary 
secretion, like hot drinks. 
Garlic: Garlic, like vitamin 
C is known for its 
anti-oxidant actions, and 
this may be its main 
contribution to cold care. 


Measuring nasal congestion 
the Common CoBd ana Nasal 

But a decongestant plus 
another decongestant will 
have an even greater effect 
on blood pressure and heart 
rate. And of graver concern 
is the danger of paracetamol 
overdose: a mixture of two 
or three different products, 
all with paracetamol, taken 
at the same time or taken 
regularly for a number of 
days, may be fatal. Alarm 
bells should always ring if a 

wiSBa a rhinomanometei 
Research Centre 

customer buys a number of 
cold products. 

High-tech future 

But magic bullets are 
popular with consumers, and 
manufacturers. And their 
popularity looks set to 
continue. Dr Eccles reveals 
that the Cold Research 
Centre is looking at products 
to "control a whole bunch of 

Attracting a great deal of 
interest is the combination ofj 
an NSAID, like ibuprofen, I 
with a decongestant. This 
double act is currently only 
available in Nurofen Cold & 

Topical products which ac 
directly on the nose are also 
being investigated by Dr 
Eccles' team. "We are 
looking at different types of 
nasal spray to look at ways 
of delivering liquids into the 
nose," he says. 

But there may be even 
more novel approaches in 
the future. Professor Jack 
Gwaltney of the University 
of Virginia believes there 
may be a need for specific 
anti-viral drugs which act or 
the virus, trying to stop its 
spread. But, if such a drug is 
produced, the cost is likely 
to be very off-putting 

The last word on a 
possible cure goes to Dr 
Eccles. "There are guite a 
few people who do 
telephone us saying they 
have a cure. But they 
believe there's a lot of 
money in this and they don' 
want to divulge it!" 

OVER THE COUNTER 21 January 19E 


Sing away a sore throat! 

National Gargling Week January 30 - February 5 1995 

Gargling is simple ! 

You can help your customers with 
sore throats by recommending 
gargling with TCP Liquid Antiseptic. 
Here are some simple guidelines to 
pass on: 

./(inuary 30 1995 marks the first day of TCP's second National 
Gargling Week, during which the antiseptic brand will he 
promoting the benefits of gargling to help sore throat sufferers. A 
£1.5 million 
national Press 
campaign, phis 
through women's 
radio and T\ \ 
will raise 
awareness of how 
simple and 
effective gargling 
with TCP is as a 
traditional self- 
medication for 
sore throats. 

five parts lap water in a cup or 

© Dilute one part TCP w 


© Take a mouthful of the diluted TCP solution and extend 

e neck by pushing the head back 
© Sing an "aarrh" sound or your favourite song if you 

© After gargling with the solution for 5-10 seconds, spit it 

© Repeat the routine once or twice. You should do this 
twice a day. 

he throat is very painful, advise the customer to gargle 
jmore often rather than taking a more concentrated solution, 
and remind them to always read the label. 
TCP Antiseptic Liquid has a unique Dual Action formula 
'with antiseptic and local anaesthetic properties which help 
[fight infection and soothe the pain of sore throats. 

iFree lor you 

Why not request copies of a free leaflet on how to gargle to 
give to customers during National Gargling Week'.' Please 
write to : NGW/OTC. Charwell Health Care. Charwell 
House. Wilsom Road. Alton. Hampshire GU34 2TJ. 

The prize 

Win a personal CD player plus 20 CDs for runners up. 
Last year. TCP found out the publics favourite gargling 

Hie i iilcs 

Tins competition is open m UK plwrman assistants onh li is not open in employees of 
Juirwell Health ( 'are, their families or agents III entries become the property at 
Jiarwell Health ( 'are. Onh one entry per person is allowed The elosin« date is 
"ebntan In 1995 Entries re, eived aftei this date n /// not he acceptable So alternatives, 
•ash or otherwise h /// be given as prizes The editoi \ decision is final and no 
'espondence can he entered una 

theme was Nessum Donna by Luciano Pavarotti. TC P now 
want to find out Britain's favourite tune among 
pharmacists and counter assistants countrywide - so let us 
know what gets vou gargling! 



your choice in 

Tick one of the following and expla 
not more than 15 words: 

1. "She loves you yeah, yeah, yeah", by The Beatles 

2. "The winner takes it all", by Abba 

3. "Careless whisper", by George Michael 
4 "Bohemian Rhapsody", by Queen 

All entries will go into the draw on February 10 1995. 
The winner will receive a personal CD player and a 
Whitney Houston CD. and there will be 20 runner-up 
prizes of the CD. 

Return the entrj form to TCP/OTC competition, Charwell 
Health Care. Charwell House. Wilsom Road. Alton. 
Hampshire Cil 34 2TJ. 



Pharmacy addres 



your pocket! 

hot bubblo both. 

First put the 'Do not disturb' 
sign on the bathroom/ 
bedroom door — preferably 
both — make sure you've set 
the video on the right 
channel and put the 
answering machine on. To 
paraphrase Captain Scott of 
the Antarctic, 'you may be 
gone lor some time..'! 

To set the scene, dim the 
lights and light a scented 
aromatherapy candle — 
lavender or sandalwood will 
help you relax. Now let the 
pampering commence! 

Head start 

You could get the ball rolling 
with a head massage. This 
benefits both your scalp and 
hair condition. You can do it 
with or without the aid of a 
scalp oil, but if your hair or 
scalp is dryer than you'd 
like, then an oil will prove 
more beneficial. Tisserand 
supply a scalp oil 
(100ml, £4.90), containing 
myrrh and palmarosa, which 
should be used on wet hair. 

Begin the massage (with 
or without oil) with a gentle 
stroking action and work 
from front to back using both 
hands. Alternate straight 
movements with circular 
ones. Then apply more 
friction using the fingertips 
(pretend you're washing 
your hair). If you are using 
an oil, work it along the 
length of your hair and leave 
for 10 minutes. It should 
then be shampooed without 
rinsing off. 

Which brings us onto the 
subjects of shampoos and 
conditioners. We all know 
our tresses are our crowning 
glory, but with more and 
more of us subjecting them 
to the daily blast of the hair 
dryer (for the 'medium' heat 
setting read 'mega-frizz'), it 
could probably do with an 
extra bit of TLC. If you have 
used a scalp oil then you 
won't need to condition it 
too. But if not... 

There's a plethora of 


shampoos and intensive 
conditioners out there. But if 
you fancy a change, how 
about a 'face mask' for your 
hair. St Ives has recently 
come out with its Wet 
Essential range which 
includes a Moisture Soak 
shampoo (330ml,£4.45) and 
a sachet of 2 Minute 
Moisture Conditioner 
(25ml, £1.45). It uses a 
liposome delivery system to 
allow its active ingredients 
(panthenol and glycerin) to 
penetrate deeper into the 
centre of the hair shaft. 
Don't let the words 'For 
critically dry hair' put you 
off. The moisture conditioner 
treatment or the enticingly 
named Moisture Drench 
Rinse (£4.45) will give your 
hair a boost, no matter what 
its condition. 

it's probabty best, in the 

long, run to invest in a good 
brush to care for your hair 
too. Mason Pearson has 
been making hair brushes 
since 1879 and says the type 
of brush you use should 
depend on the texture of 
your hair. A bristle- 
and-nylon mixture suits the 
majority, they say, but very 
wiry hair may reguire a 
special all-nylon tufted 
brush, and fine hair an 
all-bristle brush. 

Face up to winter 

With the icy blasts from the 
frozen North affecting our 
skin at this time of year — 
no matter how much we 
wrap up — a moisturising 
and deep cleansing face 
pack wouldn't go amiss. Plus 
they give you that 
tremendously satisfying 
feeling of making it crack at 
the end of the longest 15 

minutes in history. And have 
you ever noticed that the 
phone is guaranteed to ring 
as soon as you put one on? 
In fact, it is probably the besi 
way of tempting fate to 
make that bloke you met las 
week ring up and ask you 
out! Still, tonight, let it ring 
and don't worry, you've left 
the answering machine on. 

Remember that it is a 
myth that face masks give 
you spots. According to Tina 
Stainton at Network 
Management who makes 
Christy face masks, the 
china clay in a face mask 
absorbs any excess oil and 
also, by cleansing the pores, 
you are reducing the 
chances of getting spots. 
"Spots are caused by 
blocked sebaceous glands," 
she says. 

Christy is a name 
long-estbalished in 
face-packs. It has a luxury 
range which retails at just 
£0.85 a sachet! Depending 
on your skin type, there's 
Jasmin & Evening Primrose, 
Chamomile & Vitamin E, 
Cucumber & Witch Hazel 
and Oatmeal & Honey. It 
also does a Mudpack for all 
skin types which contains 
natural Fullers Earth for 
extra deep cleansing. And if 
you're still worried that a 
face pack will make your 
spots worse, then there's a I 
Medicated Hotpack which 1 
cleanses deeply but also has 
an antibacterial action. 

The neck step 

It's important to remember 1 
that complexions don't end U 
at the neck — especiaily at I 
this time of the year when J 
we're hiding behind polo 
necks and scarves. The necl 
is a tell tale sign of age (taki 
a close look at Cliff Richard) 
next time he's on the TV) 
because the skin there 
contains few sebaceous 
gtands which usually 
produce oil to moisturise 
skin and keep it supple. 
More skin care companies I 
are recoginising this and 

OVER THE COUNTER 21 January 11 

Lovely layers 

You'd think the trend towards 
'fragrance layering' would bust our 
budget. It means using a tragranced 
bath and shower gel or soap, a 
body cream or lotion, a dusting 
powder or talc, a perfumed deo as 
well as a parfum or eau de partum 

— all in your favourite perfume! 
However, OTC can reveal an 

interesting way around the expense. 
In many toiletry ranges you can buy 
bath foams, lotions, soaps etc, in 
what perfumers call 'single note' 
fragrances like peach or jasmine. 
So the trick is to find one of the 
dominant notes in the perfume you 
usually wear and buy accordingly. 
For example, if you love Lancome's 
Tresor, then settle for rose scented 
toiletries. Other examples include: 
Anais Anais — lily of the valley; 
Byzance — sandalwood or vanilla; 
Chanel No. 5 — jasmine; Escape 

— peach; Eternity — freesia; 
Jardins de Bagatelle — violet; L'Air 
du Temps — peach or rose. 

If you're not sure of your 'notes', 
wear your perfume next time you 
are out buying your toiletries and 
find a single note range which 
complements it. 

□ringing out specific 
products. Pond's 
Performance has a neck 
:reatment cream (£5.95) 
which the company says can 
reduce dryness by up to 50 
per cent in three weeks. It 
recommends putting the 
pump action bottle next to 
your toothpaste, so that 
moisturising your neglected 
aeck becomes a natural part 
pf your daily routine. 

Bust step forward 

Let's be honest, it's nol just 
the skin on our faces and 
leeks we want to keep firm: 
)ur bust is just as important. 
Ne may all moan that we're 
oo big, or too small, but 
lothing save plastic surgery 
definitely not in our budget) 
s going to change the facts. 

However, sagginess is a 
)roblem that can be 
lddressed. OK, so this is a 
mdget guide to looking 
food, but when it comes to 
mst treatments, there's no 
jetting away from Clarins. 
larins Bust Firming Gel 
ietails at £21 and is one in a 
jange of firming treatments. 
It doesn't promise to be a 
reventative treatment but 
dvises its use as soon as 
kin slackening and loss of 
fust firmness is observed. Its 
rming action is attributed to 
ie inclusion of a marine 
bmplex of algae, protein 
xtract of tuna fish, chitin, 
orsetail, witchazel and 

Now if you can't bring 
xirseli to part with such a 
un, then exercise is the 
nly answer. Ten daily 
ec-pushes are probably 




your best bet: clench your 
fists, raise your arms at right 
angles to your body and 
draw your elbows across 
your chest so that your 
elbows meet. Phew! 

All over again 

When it comes to all over 
body treats then the toiletry 
world is your oyster — even 
at low prices. You can 
luxuriate in bubbles which 
cleanse, moisturise and smell 
of your favourite things, from 
damsons to dewberries. 
Some of the more recent 

affordable bathing luxuries 
include Yardley's 
Aromatherapy range which 
has a Sensual Bathing Oil 
(£1.49) and Laboratoire 
Garnier's Neutralia 
Moisturising Foam Bath and 
Body Oil (£2.99). You can 
also exfoliate to maximise 
the softening process with 
an exfoliating soap (Potter & 
Moore does an oatmeal one 
for £0.75) or by using your 
favourite bubble bath/shower 
gel with an exfoliating 
sponge (Spontex's Calypso 
toning sponge costs £5.15). 

Oceans of lotion 

There is <i multitude ol l>od\ 
lotions in choose from I >ne 
thai has a novel I wist is 
Vaseline Intensive ( 'die's 
( )verni(|lil Body Tiealmenl 
(£3.95), which as ils name 
implies should lie used 
before bed lime. II is 
especially effective on areas 
which are prone lo dryness, 
SUCh <is the slims, heels ,111(1 
ell iows. 

A cheaper alternative is 
good old Pond's with its 
Cream & Cocoa Butter and 
Natural Aloe Vera 
Revitalising I '>< >< l\ Lot n his 
(rsp £2.55 foi 250ml). 

So there you have it! Now 
you're feeling thoroughly 
pampered and relaxed, may 
be it's time for that other 
vital requirement for looking 
good your beauty sleep! 

Feet first 

There are six simple steps to 
revive and refresh tired tootsies. 

1 . Start by rotating your feet 
(one at a time) clockwise and 
then reverse. Then flex them up 
and down a couple of times. 
Tightly curl your toes and then 
stretch them to release tension. 

2. Put some foot lotion into 
each palm and grasp one foot 
with both hands. Crabtree & 
Evelyn has introduced an Aloe 
Foot Massage Lotion (£4.95) 
and Scholl has a good range of 
products. Gently massage the 
lotion all over the foot and 
individually rotate and massage 
each toe. 

3. Starting at the ankle, firmly 
stroke and massage the whole 
foot, placing your thumbs on 
top and your fingers beneath. 

4. Press and knead with your 
thumbs and pinch along the 
arch and side of the foot. 

5. Don't forget the back of the 
heel. Massage from the Achilles 
tendon down to the base of the 

6. End by wiggling your toes — 
and your fingers too. 

You could ask your partner 
to help you out — providing 
yourfeetaren'ttoo ticklish! 

January 1995 


Y^/y^^m^ m Yr ;Y;o-w^i y^' 

Cussons is launching a 
new shower gel aimed 
specifically at 
swimmers. It says 
Imperial Leather Swim 
Shower Gel is the first 

shower gel which 
cleans hair and body 
as well as removing 
chlorine and its smell. 

Cussons is targeting 
the 22 per cent of the 
population who 
regularly go swimming 
in chlorinated pools. It 
retails at £1.59 for 

Two other new 

variants introduced by 
the company are 
Imperial Leather 
Shower Gel for Men 
and Imperial Leather 
Active Shower Gel. 
Cussons (UK) Ltd. Tel: 
0161 792 6111. 

PYY yow: IdVGiirlY tram: Y j^y 1 :-; 

Fragrant Garden collection 

Yardley's new bath, 
shower and body care 
collection adopts a 
classic English garden 
as its theme. 

Yardley Fragrant 
Gardens has three 
fragrances: lily of the 
Valley from a wild 
garden, Rose from a 
traditional garden and 
Orchid from a 
Conservatory garden. 

There are seven 
lines in each fragrance 
range: moisturising 
cream bath 
(200ml, £3.50); 
moisturising soap 
(100g.El.85, a box of 3 
x 100g,£4.95) ; 
moisturising shower 
cream (200ml,£3.50) ; 
moisturising body 
lotion (200ml, £3.50); 
body powder 
(100g,£2.50) ; body 

spray ( 100ml, £2.50) ; i 
and eau de toilette 
spray (50ml, £5.50). 

The packaging for 
the range has been 
illustrated by Charles 
Penny, a British 
painter and print 
maker, and reflects the 
type of garden to 
which each fragrance 
is suited. 

The range will be 
available from March 
and for the launch 
period trial 50ml sizes 
of the cream bath, 
shower cream and 
body lotion will be 
available, retaiiing at 

Point of sate material 
including shelf strips 
and in-store show 
cards is aiso available. 
Yardley of London. 
Tef: 01268 522711. 

Two heads more convenient than 
one with Sensodym Switch 

Sensodyne Switch is a 
new toothbrush from 
Statford-Miiler which 
has the unigue feature 
of a replacement head. 
The company believes 
the convenience of a 
spare head will 
encourage people to 
change their brush 
more frequently. 
Dentists recommend 
changing your 
toothbrush at least 
every three months but 
toothbrush sales 
suggest that people 
only change them 
every ten months. 

Switch has a flexible 
rubber neck that 
prevents too much 
pressure being placed 
on the gums while 
brushing, a rubberised 
handle for a 
comfortable grip, and 
an oval head on a 
narrow neck to reach 
the back of the mouth. 

Switch is available 
in five colours with 
medium texture 
bristles tor regular use 
(purple packs) or soft 

bristles for sensitive 
teeth or tender gums 
(green packs). 

The recommended 
retail of Switch, 
complete with one 
individually packaged 
replacement head, is 

Stafford-Miller are 
spending £1.3 million 
(MEAL) on a national 
advertising campaign 
which begins in April. 
Stafford-Miller Ltd. 
Tel: 01707 331001. 

i^irdiy Y: Yiiy 

The Fertility 
Awareness Kit offers a 
natural method of 
preventing unwanted 
pregnancies or helping 
a planned conception. 

The kit, approved by 
the Family Planning 
Association, includes a 
video which teaches 
women how to 
determine the fertile 
phase of their 
menstrual cycle using 
the sympto-thermal 
technique. This 
involves monitoring 
changes in cervical 
mucus and the position 
of the cervix. If carried 
out correctly it is said 
to have a success rate 
of 98 per cent in 
preventing pregnancy. 

The kit also includes 
a digital thermometer 
and a year's supply of 
charts to record 
temperature and 
cervical changes. It 
will be available from 
February, priced 

Wisebody Ltd. Tef: 
01483 419768. 

A spray a day... 

A range of vitamin 
sprays is now available 
from Vitall 
International. The 
sprays deliver a 
metered dose, which is 
said to be easily and 
rapidly absorbed by 
the body, and they are 
suitable for people 
who have difficulty 
swallowing tablets. 

Each daily dose from 
the Multivitamin Spray 
provides the total 
recommended daily 
allowance (RDA) of 
vitamins A,C,E,B1, B2, 
B5, B6, B12, D and 
folic acid. Vitamin C 
spray provides 100 per 
cent RDA of vitamin C 
and the Antioxidant 
Spray provides 100 per 
cent RDA ot vitamins 
A,C and E. 

Each spray contains 
one month's supply 
(120 applications) and 
has a recommended 
retail price of £7.99. 
Best of Health. Tel: 
01753 620720. 

• — /,,,;■ ' ,| / :l ,< , ■ 

extend with applicator 

Smith & Nephew has 
extended the Lil-lets 

they are grooved. The 
tampons are available 

range with its first ever in two absorbencies 

applicator tampon. 
This is a major 
departure for the 
brand which has 
dominated the digital 

and will initially be 
available in packs of 
16 (Regular, £1.75, 
Super, £1.85). 
The company is 

tampon market tor the spending £5 million 

last 40 years. 

Lil-lets applicator 
tampons differ from 
their competitors as 
they are smaller and, 
like digital Lil-lets, 

advertising the brand 
over the next year. 
Smith & Nephew 
Consumer Products 
Ltd. Tel: 0121 327 

OVER THE COUNTER 21 January 19 

Extra pain relief from Nurofen 
Plus with added codeine 

Nurofen Plus is a new 
strong analgesic from 
Crookes Healthcare 
combining ibuprofen 
with codeine. Each 
tablet contains 200mg 
ibuprofen and codeine 
12.5mg, the maximum 
dose allowed for 
Ibuprofen is a 
analgesic and codeine 
acts centrally, so 
Nurofen Plus can offer 
pain relief at two 

The company says 
the new product is 
specially formulated 
for painful conditions 
which require more 
powerful relief such as 
migraine, tension 
headaches, dental 
pain, cramping period 
pain, sciatica, 

lumbago, neuralgia 
and rheumatic pain. 

The recommended 
dose is two tablets 
initially, followed by 
one to two tablets 
every four to six hours 
if necessary, up to a 
maximum of six tablets 
within 24 hours. 

Nurofen Plus is 
available in packs of 
12 and 24 tablets 
retailing at £1.85 and 
£3.39 respectively. 

Crookes will be 
supporting the new 
product with 
advertising and public 
relations campaigns. It 
has also produced a 
Clinical Guide and a 
Pharmacy Assistants 
Training Module on 
strong pain relief. 
Crookes Healthcare 
Ltd. Tel: 0115 9507431. 

Efacal for osteoporosis 

Efacal is a new dietary 
supplement from 
Efamol which the 
ompany claims can 
help reduce the risk of 
|osteoporosis (56, £8.99). 
It combines calcium 
with essential fatty 
acids (EFAs) in the 
form of evening 
primrose oil, which has 
high concentrations of 
gamma linolenic acid 
(GLA), and with fish 
pils which contain 
sicosapentaenoic acid 
|EPA) and 

clocosahexaenoic acid 

First-time users are 
ecommended to take 
our capsules daily, 
Aath a liquid, for 12 
creeks, after which the 
lose can be reduced to 
wo capsules daily. 

Efacal is targeted at 
■vomen in their 
nid-40s and older, 
Afho are likely to be 
menopausal or 
:>ost-menopausal, and 
t is also suitable for 

women on hormone 
replacement therapy. 

The company has 
included EFAs in the 
product because 
research indicates that 
EFAs, which are 
precursors of 
prostaglandins, can 
increase gut calcium 
absorption and 
decrease urinary 
calcium excretion. 
Efamol Ltd. Tel: 01483 

Mineral Plus range from Healthcr 

The new Plus range 
Iniin I lealthcralls 
combines essential 
minerals with 
nutrients, which it says 
can help maximise the 
effectiveness oi the 

Iron Plus, includes 
vitamin C, which is 
known to help in the 
absorption ol mom Hie 
sugar-free and 
yeast-free tablets are 
available in packs of 
30 (£2.59). 

One Zinc Plus tablet 
provides 100 per cent 
of the RDA of zinc as 
well as lmg of copper 
(30, £2.29). ' 

Kelp Plus is another 
one-a-day product in 
the range. It is a multi 
mineral combination of 
calcium and iodine 
with added iron and 

■ fit 

zinc (30, £2.89). 

Dolomite Plus is a 
combination of calcium 
and magnesium with 
vitamin D, which is 
essential for the 
absorption of calcium 
and also plays a role in 

the absorption ot 
magnesium ('10 ^_2.<> ( )j 

( alcium Plus is a 
combination of calcium 
and vitamin D 
(240, £3. 45). 
Ferrosan Healthcare 
Ltd. Tel: 01932 336366. 

Savlon's new baby care toiletries 


Anadm Maximum 
Strength, a 500mg aspirin 
formulation, has been re- 
packaged in order to in- 
crease the on-shelf im- 
pact of the product. The 
new packaging empha- 
sises the Maximum 
Strength header and the 
straphne — the Powerful 
Solution to Pain — has- 
been introduced to stress 
its high strength. 
Whitehall Laboratories. 
Tel: 01628 6690 1 1 

Baby Savlon is a new 
range of baby care 
toiletries trom Zyma 
Healthcare. It consists 
of three skincare 
products, formulated 
for everyday use on 
delicate, sensitive skin, 
as well as an 
anti-bacterial surface 

Baby Savlon Cream 
(125g tub,£2.15) is a 
light, water-based 
formulation, containing 
cetrimide, zinc oxide 
and dimethicone. It 
creates a barrier to 
moisture which helps 
protect the baby from 
nappy rash. 

Baby Savlon Bath 
(300ml, £1.69) is an 
oil-free formulation 
containing aloe vera 
which is said to 

baby § 

h baby® 
I Savlon 

aM;: spray gs 

3VER THE COUNTER 21 January 1995 

Sugar-free Superted supplement 

Sugar-free Superted 
Multivitamins and 
Minerals are now 
available (30, £2.29). 
The chewable, 
strawberry- and 
raspberry- flavoured 
tablets contain the 
sweetener Xylitol and 
are free from 
preservatives and 
artificial colours. Each 
tablet comprises fifteen 
vitamins and minerals. 
The unbreakable 
plastic packs have 
child-proof caps for 
added safety. 

Ferrosan Healthcare 
has also produced an 
educational colouring 

activity booklet, The 
Day In The Life of 

Ferrosan Healthcare. 
Tel: 01932 336366. 

moisturise the skin as 
well as cleaning it. 

Baby Savlon Lotion 
(300ml, £1.75) is a 
gentle cleanser and 
moisturiser, containing 
humectants, which 
attract moisture from 
the air to the skin's 
surface, as well as 
almond oil and arachis 
oil which help seal in 
the moisture. 

Baby Savlon Spray 
(500ml, £1.69) is an 
odourless surface 
cleaner containing the 
anti-bacterial agent, 
gluconate. The 
company says the 
product can protect 
against salmonella and 
listeria, as well as 
bacteria that cause 

During 1995, 
virtually all new 
mothers will receive 
product information 
and samples. 

Zyma Healthcare. 
Tel: 01306 742800. 



Streamlined look for Eskornade 

Eskornade Spansules 
for nasal congestion 
have been repackaged 
to give greater 
'on-shelf impact and 
create a new brand 
identity'. The new 
pack is half-orange 
and half silver with a 
large capsule on the 

The new pack is 
expected to attract 
new users to the 
product and 
Goldshield is also 
introducing a new 
pack size of 12 
capsules (£3.55) to 

encourage product 

The company is also 
streamlining the brand 
by discontinuing 
Eskornade Syrup. 
Goldshield Healthcare. 
Tel: 0181-684 3664. 

Wound Wash from Savlon 

Savlon Wound Wash is 
the latest addition to 
the Savlon range. It is 
an alcohol-free first aid 
spray, containing the 
anti-bacterial agent 
gluconate, specifically 
formulated to be non- 
stinging and gentle. 

Wound Wash has a 
double action — 
washing away dirt and 
debris from a cut or 
graze and helping to 
prevent infection by 
killing bacteria. The 
100ml pack, with a 
pump spray delivery 

system, retaiis at £1.99. 
Zyma Healthcare. Tel: 
01306 742800. 

Braun moves from legs to face 

Silk-Epil Cosmetic is a 
depilatory tool for 
removing facial hair 
(£26.99). Braun 
developed the product 
as a result of market 
research which found 
that more than half the 
women who regularly 
remove facial hair are 
not happy with the 
method they use. 

Braun Silk-Epil 
Cosmetic is a 
relinement of the 

Silk-Epil for legs. It 
features a series of 
rotating discs which 
open and close like 
tweezers, removing 
hairs as they pass over. 
The speed of the disc 
action means the hairs 
are removed 
compietely and not 
merely snapped off. 
Silk-Epil Cosmetic has 
a small head designed 
to reach awkward 
spots, an adjustable 
grip on the tweezers to 

deal with fine or 
coarse hairs, and a 
rotation switch. 

Silk-Epil Cosmetic 
comes with a soothing 
after care cream, 
cleaning fluid for the 
epilation head and a 
carrying pouch. 

Braun is offering a 
complete refund to 
dissatisfied customers 
who return the product 
within 60 clays. 
Braun (UK) Ltd. Tel: 
01932 785611. 

Hungarian hat 

Three ranges of 
Hungarian toiletries 
and cosmetics have 
been introduced to the 
UK by Intrinsic Beauty. 
Helia-D, Silanus and 
Anaconda use natural 
ingredients and are 
said to contain an 
unusually high 
concentration of 
essential oils. 

Beauty masks 
(£7.39), originally 
developed for 
beauticians in 
Hungary, are the core 
products in the 
Anaconda range. 

The Helia-D range 
includes a line of skin 
care products, 
containing extract of 
sunflower stalk; 
products for sensitive 
skin; men's, babies 
and hair care lines; sun 
preparations, and 
perfumes. Prices range 
from £4.74 for 
handcream to £39.64. 

Silanus has families 
of marigold, rosemary, 
camomile and herb 
products such as body 
milks and shampoos. 
Intrinsic Beauty (UK) 
Ltd. Tel: 01403 891702. 


Wash E45, an all-over emollient cleanser, and Bath E45, the long- 
lasting bath emollient, are. just as essential for people with dry skin 
problems as Cream E45. 

Used instead of soap, bath additives and other foaming 
cleansers, thev continue the good work begun by Cream and 

Lotion E45. Dermatologically tested, free from deter 
perfumes, preservatives and other known sensitisers, E45 pi! 
complement one another and add up to a complete enjj 
programme for dry skin. 

So next time a customer asks for vour advice on a df 

>B spend £10m on new look winter remedies 

smith klino Beecham is 
nvesting £10 million in 
narketing and 
idverlising its winter 
emedies. A large 
)roportion ol this is to 
mpport the Beechams 
ind Veno's brands 
vhich have been 
elaunched and 

Veno's cough 
emedy has been 
elaunched with new 
nenthol formulations 
;aid to be 'more 
vanning and 
;oothing', with a more 
ippealing flavour. The 
lew packaging uses 
X)ld colours and an 
rpdated Veno's logo to 
ncrease on-shefi 
mpact. A TV 
idvertising campaign 
or the brand will run 
rntil February. 

The Beechams Hot 
Remedies range has 
ilso been given a new 
ook. The new packs 
eature colourful 
llustrations of the 
hree flavours — 
lemon, blackcurrant, 
md lemon and honey. 

Over the winter 
;;eason the company is 
pending more than 

£4.5 million on TV 
advertising and 
support for the 
Beechams brand. 
• The Cough and Cold 
Information Report is a 
20-page booklet 
produced by SB for 
pharmacy assistants. It 

details the symptoms 
of colds, cough and flu, 
the ingredients of 
common OTC 
treatments, and when 
to refer patients. 
Smithkline Beecham 
Consumer Healthcare 
UK. Tel: 0181 5605151. 

New look 

Sweetex is entering 
1 995 with a new 
formulation for its 
granulated varianl and 
a repackaging ol the 
entire range. 

The new Sweetex 
logo incorporates a 
spoonful ol the 
sweetener. The 
repackaging highlights 
the new improved 
flavour and 
emphasises lis use in 
healthy eating. 

The relaunch is 
backed by a £3 million 
support package 
which begins in 
January with national 
press advertising and 
will be followed by 
further ads in the 
women's press. One 

million packs will b< i 
distributed through 
slimming magazines 
and Weight Watchers. 

Almost 30 per cent 
ol sales ol artilicial 
sweeteners are 
through the pharmacy 

Crookes I lealthcare 
Ltd. Tel: 0115 9507431. 

Preconceive given GSL licence 

Lanes' Preconceive 
Folic Acid Tablets 
have been granted a 
GSL licence which 
allows the on-pack 
claim that folic acid 
can help prevent Spina 
Bifida and other 
Neural Tube Defects if 

taken one month 
before conceiving and 
tor the first trimester of 
pregnancy. A new 
90-tablet pack (£3.75) 
contains the lull 1 2 
week's course. 
Dendron Ltd. Tel: 
01923 229251. 




1 loon, recommend the whole range to loo 
For more information on the complete skin main- 
ce programme provided by the E4S dermatological skin 
range, please contact: Crookes Healthcare Limited, 
agham NG7 2LJ. 

bath oil 


washing cream 


demwrological cKin 


P&G promote 

Procter & Gamble is 
promoting its patented 
Micro-D formula in 
Head & Shoulders with 
a Freephone customer 
helpline and an 
information booklet. 

Micro-D, which is 
now being flagged 
on-pack, is said to 
promote the 
anti-dandruff action of 
zinc pyrithione and 
care for hair at the 
same time. 

The National UK 
Dandruff Hotline 
(O800 137292), in 
operation from 
February, will deal 
with customer 
enguiries and orders 
for the free booklet, 
'Exploding the Myths'. 
Procter & Gamble 
(Health & Beauty) Ltd. 
Tel: 01784 434422. 

•Colgate Actibrush 

I Colgate Actibrush 
I mouthrinse is now 
I available in a green 
p Fresh Mint variant 
| which replaces the 
I red Classic Colgate 

Ac [ i brush. It is 
1 available in both 
1 250ml (£1.99) and 
1 500ml (£2.99). 
I Colgate-Palmolive 
I Ltd. Tel: 01483 

• Slimma-Shake 

Slimma- Shake is a 
I new meal 
1 replacement drink 
I from Davina Health 
land Fitness. It is 
I available in four 
I flavours: chocolate; 
I toffee; strawberry, 

<md fruit trifle. Each 

Copperplast, a 
transdermal patch 
containing copper, has 
been developed by 
Robinson Healthcare 
for sufferers of 
rheumatism and 

Research carried out 
in Australia supports 
the old wives tale that 
placing copper next to 
the skin can benefit 
arthritic and rheumatic 
patients. Traditionally 
people have used 
copper bracelets or 
bands to obtain this 

The copper patches 
can be applied directly 
to any part of the body 
and should be 
replaced every seven 

408g pack can be 
reconstituted into 12 i 
servings and retails at 1 

Davina Health and 
Fitness Ltd. Tel: 
01142 738090. 

• Milupa additions 

Milupa has introduced!? 
two new savoury 
varieties to its range 
of Junior baby foods. I 
Chicken a la King 
and Cheesy Tomato 
dry babyfoods are 
available in lOOg 
packs which retail at 
£1.78. They contain 
no artificial 
flavourings or 
Milupa Ltd. tel: 0181 
573 9966. 

days. Copperplast is 
available in plastic 
wallets containing 
eight patches and 
retails at around £1.99. 
Robinson Healthcare. 
Tel: 01246 220022. 

Somnus and Serenity 
are two new products 
from Gerard House 
which address the 
problems of 
sleeplessness and 

Somnus is a herbal 
remedy containing 
three active 
ingredients: valerian, 
hops and wild lettuce 
which is said to 
promote relaxation 
and sleep. The 
recommended dose is 
two tablets, one hour 
before bedtime. The 
product is not 
recommended for 
children under 12 

Packaging of 
Somnus tablets is a 
distinct breakaway 
from the company's 
traditional image — a 
midnight blue and 
mauve box — but it 

Two new products 
have been added to 
the Aguafresh brand 
which has been 
relaunched by 
Smithkline Beecham 
with new packaging. 

The new toothpaste 
variant, Aguafresh 
Bicarbonate of Soda, is 
available in 50 and 
100ml tubes (£0.99, 
and £1.85 respectively) 
and 100ml pumps 

Aguafresh Floss 
(£1.59) is a new dental 
floss with distinctive 
red, white and blue 
stripes. It has the 
flavour of Aguafresh 
Minty toothpaste, 
contains fluoride and is 
wax-coated to make it 
easier to use. The floss 
is packaged in a clear 
container, the first in 
this sector, which 

retains the green logc 
The blister-packs of 3 
tablets retail at £2.89. 

The £500,000 launc 
is being supported by 
advertising on the 
London Underground 
followed by a 
consumer advertising 
campaign in women's 
magazines and 
newspapers which wi 
run from early March 

Serenity is 
positioned as a nature 
remedy for use in 
anxiety. It's key 
ingredients are hops, 
passiflora and extract: 
of valerian. The dose 
two tablets after food, 
three times daily. It's 
use is not 
recommended in 
children under 12 
years. A pack of 60 
tablets retails at £3.99 
Gerard House Ltd. Te 

shows off the colourf 

All Aguafresh 
products now feature 
the new 'wave' desk 
which the company 
believes updates the 
brand and gives it 
more impact. 
Smithkline Beecham 
Consumer Healthca) 
Tel: 0181-5605151. j 

The Cannon Babysale range has been given a new look, with colourful graphics in 
navy, turquoise and pink that highlight the brand name. The relaunch is being 
backed by a £250,000 promotional campaign. New products being launched 
simultaneously include 8oz and 4oz bottles with leakproof caps (from £1.29); 
rubber and silicone teats (£0.79 and £1.39;, soothers f£1.99j and an anti-slip bath 
mat (£3. 69]. Cannon Rubber Ltd. Tel: 01787 267000. 

SB add soda and floss to Aquafresl 

Rheumatic remedy in a patch 

48 OVER THE COUNTER 21 January 1 J 

One-steps from 
Ciba Vision 

Ciba Vision is set to 
strengthen its position 
n the contact lens care 
market during 1995 
with the launch oi 
\osept, Solo-care and 

Aosept, already the 
world's biggest-selling 
nydrogen peroxide 
solution, disinfects and 
leutralises lenses 
without the need for a 
separate neutralising 
solution or tablets. 
\odisc, a platinum disc 
)laced in the lens case, 
Neutralises the 
nydrogen peroxide 
leaving a solution of 
alt and water. Lenses 
,vill have to be left 
oaking for a minimum 
)f six hours. It will be 
ivailable in two sizes: 
25-day pack (£8.99) 
ind a three-month 
pply (£25.99). 
Solo-care is the first 
in-one solution to 
available in variants 
or rigid gas 
permeable and hard 
,enses as well as one 
or soft lenses, 
olo-care soft is 
ivailable in two sizes: 
30-day pack (£7.49) 
nd three months 
upply (£17.99). 
olo-care hard is only 
vailable in a 30-day 
>ack (£5.99). 

Unizyme is a protein 
emover tablet and is 
uitable for all lenses 
2, £6.95). Each tablet 
iias a score mark for 
asy breakage so it 
an be used in single 
nd double chamber 
ns storage cases. 
The company is 
upporting the range 
'unng 1995 with a 
3.5 million support 

~iba Vision (UK) Ltd. 
el: 01489 785399. 

E3 b 

E3K ES O £3 E3 

Sport in the sun with Nivea 

Sporstmen and women 
can now protect 
themselves from the 
sun with a new Nivea 
sub brand — Nivea 
Sun Sport. 

The three products 
in the range are: an 
SP5 (£5.99), an SP15 
(£6.49) and a block 
SP25 lotion (£6.99). 
The formulations are 
light, non-greasy 
lotions with a fresh 
fragrance. The 150ml 
packs are 'chunkier' 
than the usual Nivea 
packs and have a 
distinctive yellow cap. 

The standard range 
of Nivea Sun will now 
be described on pack 
as Moisturising Sun 
Lotion/Cream. The 

number of 400ml 
options has also been 
increased and there is 
now a 400ml pack size 
in SPF4 (£10.99), SPF6 
(£11.49), SPF8 
(£11.99), SPF12 
(£12.49), SPF16 
(£12.99) and SPF20 

After Sun Liposome 
Cream (75ml, £4.75) 
contains liposome 
microspheres which 
transport avocado oil 
and vitamin E into the 
skin, where they are 
said to help the 
regeneration of the 
skin's natural 
Smith & Nephew 
Consumer Products. 
Tel: 0121 327 4750. 

"old relief with 

.emplus capsules and 
'Owders are two GSL 
roducts for the relief 
f cold symptoms, 
^ach capsule contains 
OOrng paracetamol, 
5mg caffeine and 
mg phenylephrine, 
he recommended 
ose for adults and 
hildren over 12 is one 
r two capsules every 
iree to four hours to a 
laximum of eight in 
4 hours (24, £2.09). 
Each sachet of 
emplus powder 


contains 650mg 
paracetamol and 50mg 
vitamin C. The 
recommended dose for 
adults and children 
over 12 is one sachet 

every four hours to a 
maximum of four in 24 
hours (five, £1.37; 
ten, £2.29). 

Adcock Ingram (UK). 
Tel: 01533 650350. 

All-in-One cold and flu relief 

Beeehams All-ln-( )ne 
is the firsl ( iSL 
multi-symptom cold 
and flu remedy 
presented in a liquid 
form (160ml, £2.99). 

Each 20ml dose ol 
Liquid contains 500mg 
paracetamol, 200mg 
giicuphenesm, and 
H)mq phenylephi me 
The non-drowsy 
formulation oilers 
rebel from headaches, 
aches, blocked noses 
and chesty coughs, 

The recommended 
dose of All-ln-< )ne for 
adults and children 
over 12 years is 20ml 
every loin hours lo <i 
maximum of four doses 
in 24 hours. For 
children aged six lo 1 2 
years the dose should 
be halved (10ml). A 
plastic cup with 10ml 
and 20ml graduations 
is included to ensure 
accurate dosing. 

All-In-( )ne is being 
supported with a £1 .5 
million TV advertising 
Smithkline Beecham 
Consumer Healthcare 
UK. Tel: 0181 560 

Meltus cough control in a capsule 

Seton Healthcare has 
launched a new 
Pharmacy product: 
chewable liquid-filled 
Meltus Cough Control 
Capsules (10, £2.59). 
The strawberry- 
flavoured, sugar-free 
capsule contains the 
cough suppressant 
hydrobromide and is 
suitable for adults and 
children over 1 2 years. 

Each capsule is said 
to control coughs for 
four hours. The 
maximum dose is six 
capsules in 24 hours. 

The capsules are 
contra-indicated in 
patients on mono- 
amine oxidase 
inhibitors (MAOIs), 

used to treat 
depression, as such 
drugs may interact with 
Seton Healthcare 
Group pic. Tel: 0161 
652 2222. 

• Vichy's Adaptive 

Vichy's latest 

moisturiser, Adaptive, 

is said to be the first 

facial cream 
Iformulated to suit 
■ combination skin. 

It gives a matt 
[effect on oily areas 
1 without drying the 
[dry areas and 
jhydrates the dry areas 

without making the 
joily areas worse. It 

will be d veil la I ili troin 
I February at £8.95 for 
la 40ml pot. 
ICosmetigue Active 

(UK) Ltd. Tel: 01235 


• Tisserand Organks 

Aromatherapy is 
extending its range of 
oils with a collection 
of Organic essential 
oils. Obtained trom 
plant grown without 
the use of artificial 
pesticides and 
fertilisers, the Organic 
oils are aimed at a 
select audience. The 
range includes Rose 
Phytol and prices 
range from £7.30 to 

Products Ltd. Tel: 
01273 325666. 

>VER THE COUNTER 21 January 1995 


Aliica, the latest Lynx variant from Elida Gibbs, is 
described as 'deep and sensual with a fresh top note 
set on a warm Oriental base'. The new variant will be 
represented by a red and green icon on the familiar 
black and silver Lynx packaging. The company is 
supporting Lynx during 1995 with a £8.5 million 
advertising spend which will include specific support 
behind Africa. 

Elida Gibbs Ltd. Tel: 0171 486 1200 

Logical approach to 


Dental Logic is a new 
range of dental care 
products from Philips 
consisting of two 
toothbrushes, a dental 
centre and a waterjet. 

The key feature of 
the new range is a 
new 'soft pressure' 
system which is 
combined with the 
'Clean & Clear' brush 
movement. With the 
'soft pressure' system, 
if the brush is pressed 
too hard against the 
teeth, the brush head 
clicks back, warning 
the user of excess 
pressure. The head 
automatically resets to 
its original position 
when pressure is 
reduced to normal. 
This allows effective 
brushing without 
damaging the gums 
and teeth. 

The 'Clean & Clear' 
brush movement 
moves the head of the 
brush in two directions 
at two speeds, fast 
longitudinal strokes to 
loosen the plague and 

slow rolling 

movements to dislodge 
it from the teeth. 

The Philips HP600 
waterjet complements 
the new range of 
brushes, and is said to 
improve the 
effectiveness of 
massages gums and 
helps remove food 
residues. A full 
pressure button 
provides momentary 
full pressure to 
dislodge stubborn 

The recommended 
retaii prices are: 
Philips HP400 
toothbrush, £44.99; 
HP550 toothbrush, 
£59.99; HP600 
Waterjet, £49.99; 
HP700 dental centre, 
£94.99; Replacement 2 
bristle pack, 
£2.75 and 

Replacement 4 bristle 
pack, £4.95. 
Philips Domestic 
Appliances and 
Personal Care. Tel: 
0181 689 2166. 

• Healthcrafts High 
Strength CLO 

Healthcrafts has 
introduced a new 
High Strength Cod 
Liver Oil (30,£2.89). 
Each capsule 
provides l,000mg of 
iCLO, 100 per cent of 
the EC's 

Recommended Daily 
Amounts for vitamins 
A,D and E as well as 
Omega 3 fatty acids. 
Ferrosan Healthcare 
Ltd. Tel: 01932 

• Mycil leaflet 

Crookes Healthcare 
has produced a 
consumer leaflet 'A 
Step by Step Guide to 
Healthy Feet' to raise 
awareness of athlete's 

The leaflet was 
written in conjunction 
with the London Foot 
Hospital and is 
intended to help 
pharmacy staff advise 
on the condition. 
Crookes Healthcare. 
Tel: 0115 9507431. 

• Triple-headed 

Superbrush, a 
toothbrush is now 
available from 

Its design is said to 
make it possible to 
clean all surfaces of 
the teeth in one 
brushing movement. 
Available in three 
sizes, it retails at 

Dent-O-Care Ltd. Tel: 

Mebendazole tablets join Pripsen range 

Seton Healthcare has 
added chewable 
mebendazole tablets to 
its Pripsen range. 
Pripsen Mebendazole 
tablets containing 
lOOmg mebendazole 
are indicated for the 
treatment of 

The two-tablet pack, 
which retails at £1.89, 
is the only product on 
the market which 
offers a second tablet, 
at no extra cost, if 
re-infection occurs. 
The first dose kills the 
threadworm but ii 
re-infection occurs the 
second tablet is taken 
14 days later to kill any 
threadworms produced 
from residual eggs. 

The orange flavour 
tablets are sugar-free 
and contain no 
artificial colours. 
Pripsen Mebendazole 
tablets are suitable for 
adults and children 

' 5-UGM? Bjj t 

from two years of age 
but their use is 
contra-indicated in 
pregnant women as 
they may cause 
damage to the foetus. 

Seton Healthcare is 
supporting the launch 
with pharmacy trade 

promotions and an 
on-going public 
relations campaign 
targeted at school 
nurses, practice nursesj, 
and health visitors. 
Seton Healthcare 
Group pic. Tel: 0161 
652 2222. 

Hc45, the 1 per cent hydrocortisone cream from Crookes Healthcare has been 
repackaged to highlight the indication extension to treat mild to moderate 
eczema. The new pack is designed to be more user-friendly, with illustrations of 
all the usages of Hc45 to help the customer and pharmacist identify the conditioi 
which can be treated with the cream. Crookes Healthcare Ltd. Tel: 01 15 9507431 

OVER THE COUNTER 21 January 19 

For the past two weeks I have been off work with 
the cold/flu bug that practically everyone I speak to 
has either got or is recovering from. At first not 
being able to talk didn't seem to be a problem — in 
tact, some thought it was absolute bliss! But 
coughing and sneezing all night and not being able 
to breathe properly did make my life rather 
miserable. Things have been made more 
complicated regarding treatment for my ailments 
because I am four months pregnant, and despite 
several reassurances about what is safe, I seem to 
be totally incapable of making a decision about just 
what to take. I have stuck to the easy options: 
honey and lemon drinks, Olbas Oil and tissues are 
my life savers at the moment. 

The two months leading up to Christmas were 
very busy with dispensing but the retail side was 
guiet compared to previous years. This, we are 
sure, is due to the opening of a large shopping 
centre in the town. We were prepared for this. 
Christmas orders were careful and general assistance was at its best at all 
times. This, however, did not encourage local people. 

While I have been at home I have had plenty of time to read several 
women's magazines. I do not usually have the opportunity to read this 
kind of magazine in any detail, and was absolutely amazed at how much 
of the magazines were filled with articles about being slim and healthy. In 
at least three, women were photographed before and after losing vast 
amounts of weight and saying how much their life had changed, what it 
had done for their confidence and how their relationships had improved. 
None of them said how important changing your eating habits are or 
whether the weight lost was due to a fad diet and a bit of exercise. 

At this time of year sales of slimming aids are high as most people seem 
to want a guick and simple way to lose those extra pounds gained over 
Christmas. Slimfast seems to provide the easy option. The advertising 
campaign is effective and this product seems to be first choice with most 
shoppers. Although the women in the magazines should be congratulated 
for their marvellous achievements, I wonder if the magazines' efforts 
would not be better spent on promoting a more healthy way of living, 
rather than promoting guick diets which usually have little lasting effect. 

The same is true of vitamin supplements. A few glossy magazines have 
some good information about how much of this and that vitamin we need 
for a healthy existence but only how to get it from a tablet and not from a 
healthy diet. Surely one should promote the idea that vitamin supplements 
should be taken if necessary but always in conjunction with a healthy diet. 

M<**, Br BAM! 


OH A/O.'.' we WAN 
WS ff/T/A/6 OUR 

MAILS .'! f YEA 

Mono film output by London Scanninq. North London Printed by Riverside Press Ltd, St Ives pic, Gillinqham, Kent Published bv Benn Put*. 
Lontents i Benn Publications Ltd 1994 All rights reserved No part of the publication may be reproduced, stored in a retrieval system or transmitted in any form or bv 

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OVER THE COUNTER 21 January 1995 



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